JP2018117778A - X-ray diagnosis apparatus, image processing apparatus, and program - Google Patents

Abstract

The present invention generates superimposed images that are aligned in time series when images acquired in real time from different modalities are superimposed and displayed. According to an embodiment, an X-ray diagnostic apparatus includes a first acquisition section, a second acquisition section, a calculation section, a buffer section, a superimposed image generation section, and a display section. . The first acquisition unit acquires an X-ray image of the subject in real time. The second acquisition unit acquires a medical image of the subject from another modality in real time in parallel with the acquisition of the X-ray image. The calculation unit calculates the time difference between the time until the X-ray image is displayed and the time until the medical image is displayed, based on the biological information of the subject. The buffer section outputs the X-ray image after the time difference has elapsed. The superimposed image generation unit sequentially generates superimposed images in which the output X-ray image and the medical image are superimposed. The display unit displays the superimposed image. [Selection diagram] Figure 1

Description

  Embodiments described herein relate generally to an X-ray diagnostic apparatus, an image processing apparatus, and a program.

  Currently, an X-ray diagnostic apparatus has a function of displaying, for example, an X-ray image and an ultrasonic image (or an X-ray moving image and an ultrasonic moving image) superimposed on each other. This type of X-ray diagnostic apparatus may superimpose, for example, an X-ray image acquired in advance and an ultrasonic image acquired in advance from another modality (medical image diagnostic apparatus) by the above function. The X-ray diagnostic apparatus may superimpose an ultrasonic image acquired in advance from another modality on an X-ray fluoroscopic image acquired in real time, for example, by the above function.

JP 2014-61093 A

  However, the X-ray diagnostic apparatus as described above is usually not particularly problematic, but according to the study of the present inventor, when superimposing X-ray images and ultrasonic images respectively acquired in real time, There is a possibility that a shifted superimposed image is generated. For example, there may be a time difference between the time until the X-ray image acquired in real time is displayed on the display and the time until the ultrasonic image acquired in real time is displayed on the display. That is, there may be a delay due to image processing or a delay due to transmission / reception from an external device. Therefore, when superimposing X-ray images and ultrasonic images acquired in real time from different modalities, there is a possibility that a superimposed image shifted in time series may be generated due to the time difference or delay described above.

  An object of the present invention is to provide an X-ray diagnostic apparatus, an image processing apparatus, and a program capable of generating a superimposed image having a uniform time series when images acquired in real time from different modalities are superimposed and displayed.

  According to the embodiment, the X-ray diagnostic apparatus includes a first acquisition unit, a second acquisition unit, a calculation unit, a buffer unit, a superimposed image generation unit, and a display unit. The first acquisition unit acquires an X-ray image of the subject in real time. The second acquisition unit acquires the medical image of the subject from other modalities in real time in parallel with the acquisition of the X-ray image. The calculation unit calculates a time difference between the time until the X-ray image is displayed and the time until the medical image is displayed based on the biological information of the subject. The buffer unit outputs the X-ray image after the time difference has elapsed. The superimposed image generation unit sequentially generates a superimposed image in which the output X-ray image and the medical image are superimposed. The display unit displays the superimposed image.

It is a block diagram which shows an example of a structure of the X-ray diagnostic apparatus which concerns on 1st Embodiment. It is a figure which shows the delay time until an X-ray image and an ultrasonic image are displayed on a display. It is a figure which shows an example of the method of calculating a time difference from the electrocardiogram waveform accompanying an X-ray image and an ultrasonic image. It is a flowchart for demonstrating the operation | movement in the embodiment. It is a block diagram which shows an example of a structure of the image processing apparatus which concerns on 2nd Embodiment.

  Hereinafter, each embodiment will be described with reference to the drawings. Elements that are the same as or similar to those already described are denoted by the same or similar reference numerals, redundant description is omitted, and elements that have not been described are mainly described.

(First embodiment)
FIG. 1 is a block diagram illustrating a configuration example of an X-ray diagnostic apparatus 1 according to the first embodiment. The X-ray diagnostic apparatus 1 includes a bed having an X-ray high voltage apparatus 2, an X-ray tube 3, an X-ray detector 4, a support frame 5, and a top plate 6, an electrocardiograph 7, an image generation circuit 8, A communication interface circuit 9, an input interface circuit 10, a control circuit 11, a processing circuit 12, a buffer circuit 13, a storage circuit 14, and a display circuit 15 are provided.

  The X-ray high voltage apparatus 2 generates a tube current supplied to the X-ray tube 3 and a tube voltage applied to the X-ray tube 3. The X-ray high voltage apparatus 2 supplies tube currents suitable for X-ray imaging and X-ray fluoroscopy to the X-ray tube 3 under the control of the control circuit 11 and is suitable for X-ray imaging and X-ray fluoroscopy, respectively. The tube voltage is applied to the X-ray tube 3.

  The X-ray tube 3 generates X-rays based on the tube current supplied from the X-ray high voltage device 2 and the tube voltage applied by the X-ray high voltage device 2. X-rays generated from the X-ray tube 3 are applied to the subject P. The X-ray tube 3 may be, for example, a rotary anode type X-ray tube or another type of X-ray tube such as a fixed anode type X-ray tube.

  The X-ray detector 4 detects X-rays generated from the X-ray tube 3 and transmitted through the subject P. The X-ray detector 4 includes, for example, a flat panel detector (FPD). The FPD has a plurality of semiconductor detection elements. The semiconductor detection element includes a direct conversion type and an indirect conversion type. The direct conversion type is a type in which incident X-rays are directly converted into electrical signals. The indirect conversion form is a form in which incident X-rays are converted into light by a phosphor and the light is converted into an electrical signal. An image intensifier may be used as the X-ray detector 4.

  Electrical signals generated by a plurality of semiconductor detection elements as X-rays are incident are output to an analog-to-digital converter (A / D converter) (not shown). The A / D converter converts an electrical signal into digital data. The A / D converter outputs digital data to the image generation circuit 8.

  The support frame 5 movably supports the X-ray tube 3 and the X-ray detector 4 that are arranged to face each other. Specifically, the support frame 5 corresponds to a C arm. As the support frame 5, an Ω arm may be used instead of the C arm. Further, the support frame 5 is not limited to a structure with a C arm and an Ω arm, and has, for example, a structure with two arms (for example, a robot arm) that independently support the X-ray tube 3 and the X-ray detector 4. You may do it. The support frame 5 is not limited to the over tube system, the under tube system, and the like, and can be applied to any form.

  A couch (not shown) has a top 6 (also referred to as a prone table) on which the subject P is placed. A subject P is placed on the top 6.

  For example, the driving device (not shown) drives the support frame 5 and the bed under the control of the control circuit 11. At the time of X-ray fluoroscopy and X-ray imaging, the subject P placed on the top 6 is placed between the X-ray tube 3 and the X-ray detector 4. The driving device may rotate the X-ray detector 4 with respect to the X-ray tube 3 under the control of the control circuit 11.

  The electrocardiograph 7 acquires an electrocardiogram (ECG) of the subject P via an electrode (not shown) attached to the subject P. The electrocardiograph 7 outputs the acquired electrocardiogram waveform to the image generation circuit 8 together with time information. The electrocardiograph 7 outputs the acquired electrocardiographic waveform together with time information to an ultrasonic image generation circuit (not shown) of the ultrasonic diagnostic apparatus UL. In the ultrasonic image generation circuit of the ultrasonic diagnostic apparatus UL, for example, an ultrasonic image is generated based on the output of an ultrasonic probe such as a transesophageal echocardiography (TEE) probe, and an electrocardiographic waveform is generated in the ultrasonic image. And time information. Thereafter, the ultrasonic diagnostic apparatus UL transmits an ultrasonic image with an electrocardiographic waveform and time information attached to the X-ray diagnostic apparatus 1. The electrocardiograph 7 may be an external device that is not built in the X-ray diagnostic apparatus 1 or may be built in the ultrasonic diagnostic apparatus UL.

  The image generation circuit 8 generates an X-ray image based on digital data output from the X-ray detector 4 via an A / D converter (not shown). For example, the image generation circuit 8 generates a plurality of X-ray images taken in time series. The image generation circuit 8 associates the generated X-ray image with the electrocardiogram waveform and time information and outputs them to the storage circuit 14 or the like. The image generation circuit 8 may output the generated X-ray image to the display circuit 15.

  The communication interface circuit 9 is, for example, a circuit related to a network, the ultrasonic diagnostic apparatus UL, and an external storage device (not shown). Data such as X-ray images and analysis results obtained by the X-ray diagnostic apparatus 1 can be transferred to other apparatuses via the communication interface circuit 9 and the network. Further, the communication interface circuit 9 can receive an ultrasonic image or the like from the ultrasonic diagnostic apparatus UL. Hereinafter, when information is exchanged via the communication interface circuit 9, the description “through the communication interface circuit 9” is omitted.

  The input interface circuit 10 includes X-ray irradiation conditions such as X-ray imaging conditions and fluoroscopy conditions desired by the operator, fluoroscopy / imaging positions, irradiation ranges, and regions of interest in the X-ray image (region of interest). : ROI) or the like is input according to the operator's instruction. Specifically, the input interface circuit 10 captures various instructions, commands, information, selections, and settings from the operator into the X-ray diagnostic apparatus 1 or the processing circuit 12.

  The input interface circuit 10 includes a trackball for setting a region of interest, a switch button, a mouse, a keyboard, a touch pad for performing an input operation by touching an operation surface, and a display screen and a touch pad. It is realized by a touch panel display. The input interface circuit 10 is connected to the control circuit 11, converts the input operation received from the operator into an electrical signal, and outputs the electrical signal to the control circuit 11.

  In the present specification, the input interface circuit 10 is not limited to one having physical operation components such as a mouse and a keyboard. For example, an example of the input interface circuit 10 includes an electric signal processing circuit that receives an electric signal corresponding to an input operation from an external input device provided separately from the apparatus and outputs the electric signal to the control circuit 11. It is.

  The control circuit 11 is a processor that controls each circuit and driving device in the X-ray diagnostic apparatus 1. The control circuit 11 temporarily stores information such as an operator instruction input from the input interface circuit 10 in a memory (not shown). The control circuit 11 controls the X-ray high voltage device 2 and the driving device in order to perform X-ray imaging and X-ray fluoroscopy in accordance with an operator instruction stored in the memory. The control circuit 11 controls the X-ray image generation processing in the image generation circuit 8 and the superimposed image generation processing in the processing circuit 12 in accordance with an operator instruction stored in the memory.

  The processing circuit 12 reads out the control program stored in the storage circuit 14 in response to a start instruction input by the operator via the input interface circuit 10. The processing circuit 12 executes each function for generating a superimposed image in which an X-ray image and a medical image are superimposed according to the read control program. The above functions include, for example, a first acquisition function 12a, a second acquisition function 12b, a calculation function 12c, a buffer function 12d, and a superimposed image generation function 12e. Note that the processing circuit 12 may create a moving image by processing a plurality of X-ray images along the time series stored in the storage circuit 14.

  The first acquisition function 12a is a function for acquiring an X-ray image of the subject P from the storage circuit 14 in real time. Here, in this application, “real time” means displaying images acquired in parallel with sequentially acquiring images, and does not limit the delay time until the acquired images are displayed. The X-ray image is associated with the biological information of the subject P. The biological information corresponds to, for example, an electrocardiogram waveform or a respiratory waveform of the subject P. The respiratory waveform is acquired by, for example, a respiratory sensor (not shown). The first acquisition function 12a outputs the acquired X-ray image to the buffer function 12d. The “X-ray image” may be called a “first image”.

  The second acquisition function 12b is a function for acquiring in real time an ultrasound image that is a medical image of the subject P from the ultrasound diagnostic apparatus UL that is another modality. Specifically, the second acquisition function 12b acquires in real time an ultrasound image whose time series matches the X-ray image in parallel with the acquisition of the X-ray image by the first acquisition function 12a. The ultrasonic image is associated with the biological information of the subject P. The second acquisition function 12b outputs the acquired ultrasonic image to the superimposed image generation function 12e. The “medical image” may be called a “second image”. An “ultrasonic image whose time series coincides with an X-ray image” may be called “an ultrasonic image synchronized with an X-ray image” or “an ultrasonic image corresponding to a dynamic change of an X-ray image”. Good.

  Here, it is assumed that the X-ray image and the ultrasound image acquired both start image generation in a state in which phases related to biological information (for example, an electrocardiographic phase and a respiratory phase) coincide with each other. In addition, it is assumed that the biological information associated with the X-ray image and the ultrasound image is acquired from the same device (for example, an electrocardiograph 7 or a respiration sensor).

  The calculation function 12c is a function for calculating a time difference between the time until the X-ray image is displayed on the display and the time until the ultrasonic image is displayed on the display, based on the biological information of the subject P. is there. For example, the calculation function 12c calculates the time difference based on the biological information attached to the X-ray image and the biological information attached to the ultrasonic image.

  Note that the “time until display on the display” includes a time related to a delay due to image processing or a delay due to transmission / reception from an external apparatus in each modality. In addition, “time until the X-ray image is displayed on the display” and “time until the ultrasonic image is displayed on the display” are respectively set to “time until the first acquisition function 12a acquires the X-ray image”. It may be read as “time” and “time until the second acquisition function 12b acquires an ultrasound image”.

  FIG. 2 is a diagram showing a time until an X-ray image is displayed on the display (delay time Δα) and a time until an ultrasonic image is displayed on the display (delay time Δβ). FIG. 2 shows the delay time larger than the actual time.

  Assume that generation of an X-ray image and an ultrasound image is started at a time t0 in a state where the phases of the electrocardiographic waveforms match. When the X-ray image and the ultrasound image are displayed individually, the X-ray image is displayed on the display at time t1, and the ultrasound image is displayed on the display at time t2. That is, there is a time difference Δt (= | t1−t2 |) in the time when the X-ray image and the ultrasonic image that have been generated almost simultaneously are displayed on the display.

FIG. 3 shows an example of a method for calculating the time difference Δt in FIG. For example, as shown in FIGS. 3A to 3C, an X-ray image (X ₀ ) and an ultrasound image (U ₀ ) that are generated at time t0 are obtained from the electrocardiograph 7, respectively. An electrocardiographic waveform EW1 is attached. The subsequent X-ray image (X ₁ ) and ultrasonic image (U ₁ ) are each accompanied by an electrocardiographic waveform EW2. The electrocardiogram waveform may be set so as to have a time length larger than an assumed delay time (time difference).

As a method for calculating the time difference Δt, for example, there is a method of comparing an electrocardiogram waveform attached to an X-ray image and an electrocardiogram waveform attached to an ultrasonic image. When an electrocardiographic waveform of an X-ray image having a short delay time is used as a reference, as shown in FIGS. 3D and 3E, the X-ray image (X ₁ ) displayed at time t2 is attached. A time difference Δt (also referred to as a buffer delay) is calculated by comparing the electrocardiogram waveform EW2 with the electrocardiogram waveform EW1 attached to the ultrasonic image (U ₀ ) displayed at time t2. Specifically, the electrocardiogram waveform EW1 and the electrocardiogram waveform EW2 are overlapped to obtain the overlapping waveform time length (T _OL ) corresponding to the shaded portions OL1 and OL2. The time difference Δt can be calculated by taking the difference between the time length (T _EW ) of the electrocardiogram waveform and the time length (T _OL ). As a calculation method, a respiratory waveform may be used instead of the electrocardiographic waveform.

  The buffer function 12d receives the time difference information from the calculation function 12c, and outputs the X-ray image received from the first acquisition function 12a to the superimposed image generation function 12e after the time difference has elapsed. For example, the buffer function 12d stores the X-ray image in the buffer circuit 13, and outputs the X-ray image in the buffer circuit 13 after a time difference has elapsed. Note that the buffer function 12 d may store an X-ray image in a buffer area (not shown) in the storage circuit 14 instead of the buffer circuit 13.

  The superimposed image generation function 12e is a function that sequentially generates superimposed images by superimposing the X-ray image output from the buffer function 12d and the ultrasonic image output from the second acquisition function 12b. The phase of the X-ray image and the ultrasonic image received by the superimposed image generation function 12e is aligned by the buffer function 12d. Therefore, the superimposed image generation function 12e can generate a superimposed image without a time lag in superimposing the X-ray image and the ultrasonic image.

  The X-ray image and ultrasonic image to be superimposed may be either a two-dimensional image or a three-dimensional image acquired in real time. A three-dimensional image acquired in real time may be referred to as a four-dimensional image. The form of the superimposed image may be a form in which the images of the target organs are superimposed, or a form in which the target organs are arranged. In the former case, for example, there is a form in which a cross-sectional image (ultrasonic image) of the heart is superimposed on the position of the heart on the fluoroscopic image. Further, for example, there is a form in which a cross-sectional image (ultrasound image) of the heart is superimposed on a 3D blood vessel image (X-ray image) of the heart by an angiography method. In the latter case, a desired image may be arranged.

  Note that the superimposed image generation function 12e may execute alignment of both images when the X-ray image and the ultrasonic image are superimposed. As an alignment method, for example, when the ultrasound probe is a transesophageal probe, by detecting the coordinates of the transesophageal probe from the transesophageal probe image in the X-ray image, the coordinate system of the X-ray image and the ultrasonic wave A technique for associating with the image coordinate system can be used. This technique is not limited to a transesophageal probe, and can be similarly used as long as it is an in-vivo probe that transmits ultrasonic waves from the inside of the subject P. Further, for example, when the ultrasonic probe is an external probe, by detecting the coordinates of the ultrasonic probe based on the output of the position sensor attached to the ultrasonic probe, the coordinate system of the X-ray image and the ultrasonic image A technique for associating with a coordinate system can be used. As another method of alignment, for example, a method is used in which a specific shape portion in the subject is used as a landmark, and the coordinates of the landmark in the X-ray image are associated with the coordinates of the landmark in the ultrasonic image. Is possible.

  The buffer circuit 13 is a storage circuit that temporarily stores an X-ray image. The buffer circuit 13 includes a memory for recording electrical information such as a semiconductor memory, and peripheral circuits such as a memory controller and a memory interface associated with the memory. The “buffer circuit” may be called a “buffer storage circuit” or a “buffer memory”. The same applies to the following embodiments.

  The storage circuit 14 includes a memory for recording electrical information such as an HDD (Hard Disk Drive), and peripheral circuits such as a memory controller and a memory interface associated with the memory. The memory is not limited to HDD, but SSD (solid state drive), magnetic disk (floppy (registered trademark) disk, hard disk, etc.), optical disk (CD, DVD, Blu-ray (registered trademark), etc.), semiconductor memory, etc. Can be used as appropriate.

  The storage circuit 14 includes various X-ray images generated by the image generation circuit 8, a superimposed image generated by the processing circuit 12, a system control program for the X-ray diagnostic apparatus 1, a diagnostic protocol executed by the control circuit 11, and an input Various data groups such as an operator's instruction sent from the interface circuit 10, imaging conditions related to X-ray imaging and fluoroscopic conditions related to X-ray fluoroscopy, error information, and the data sent via the communication interface circuit 9 and the network. Various data are stored.

  The display circuit 15 includes a display that displays medical images, an internal circuit that supplies a display signal to the display, and peripheral circuits such as a connector and a cable that connect the display and the internal circuit. The display displays an input screen related to input of fluoroscopy / imaging position, X-ray irradiation conditions, and the like.

  The display displays superimposed images that are sequentially generated by the processing circuit 12. The display may display a plurality of X-ray images generated by the image generation circuit 8 alone or in a moving image in a region different from the superimposed image. The display may display a moving image by arranging the X-ray image, the ultrasonic image, and the superimposed image.

  Next, the operation of the X-ray diagnostic apparatus 1 configured as described above will be described with reference to the flowchart of FIG. In the following description, the superimposed image generation processing by the processing circuit 12 will be mainly described. The superimposed image generation process is started by the operation of the operator.

  First, the subject P is placed on the couch top 6 and the electrodes of the electrocardiograph 7 are attached to the subject P. Thereby, the electrocardiograph 7 acquires the electrocardiogram waveform of the subject P, and outputs this electrocardiogram waveform together with time information to the image generation circuit 8 and the ultrasonic diagnostic apparatus UL.

  On the other hand, a transesophageal probe connected to the ultrasonic diagnostic apparatus UL is inserted from the esophagus of the subject P, and the tip of the transesophageal probe is located below the heart of the subject P. Thereby, in the ultrasonic diagnostic apparatus UL, an ultrasonic image is generated based on the output of the transesophageal probe, and an electrocardiographic waveform and time information are attached to the ultrasonic image. Thereafter, the ultrasonic diagnostic apparatus UL transmits an ultrasonic image with an electrocardiographic waveform and time information attached to the X-ray diagnostic apparatus 1.

  The X-ray diagnostic apparatus 1 sets the imaging conditions of the subject P by the operation of the operator, starts X-ray fluoroscopy or X-ray imaging of the subject P, and sequentially acquires the X-ray images of the subject P. Generated and stored in the storage circuit 14. Thereafter, step ST1 is started.

  In step ST1, the first acquisition function 12a acquires an X-ray image of the subject P from the storage circuit 14 in real time. The first acquisition function 12a outputs the acquired X-ray image to the buffer function 12d. The buffer function 12d stores the X-ray image in the buffer circuit 13.

  In step ST2, the second acquisition function 12b acquires an ultrasonic image of the subject P from the ultrasonic diagnostic apparatus UL in real time in parallel with the acquisition of the X-ray image in step ST1. That is, step ST1 and step ST2 may be performed simultaneously.

  In step ST3, the calculation function 12c calculates a time difference Δt between the time until the X-ray image is displayed and the time until the ultrasonic image is displayed based on the biological information of the subject P.

  In step ST4, the buffer function 12d outputs the X-ray image in the buffer circuit 13 after the time difference Δt has elapsed.

  In step ST5, the superimposed image generation function 12e sequentially generates a superimposed image by superimposing the X-ray image output in step ST4 and the ultrasonic image acquired in step ST2.

  In step ST6, the display circuit 15 displays the superimposed images sequentially generated by the processing circuit 12 as a moving image. After step ST6, the superimposed image generation process ends.

  As described above, according to the present embodiment, an X-ray image of a subject is acquired in real time, and a medical image of the subject is acquired from other modalities in real time in parallel with acquisition of the X-ray image. Then, based on the biological information of the subject, the time difference between the time until the X-ray image is displayed and the time until the medical image is displayed is calculated, and the X output after the time difference has elapsed. A superimposed image in which a line image and a medical image are superimposed is sequentially generated, and the superimposed image is displayed.

  Therefore, when images acquired in real time from different modalities are superimposed and displayed, it is possible to generate a superimposed image in time series.

  In addition, since it is possible to prevent a time lag at the time of generating a superimposed image due to a delay due to image processing or a delay due to transmission / reception from an external device, it is possible to provide a highly visible superimposed image. Then, by using a highly visible superimposed image, treatment based on accurate information is possible, and improvement in procedure efficiency can be expected. Supplementally, the configuration in which both the X-ray image and the medical image are acquired in real time can generate a superimposed image that follows a dynamic change, unlike when either one is acquired in advance. Treatment based on the superimposed image is possible. For example, when one of the images is acquired in advance, the heartbeat does not match with the image acquired in real time, and a superimposed image following a dynamic change cannot be generated. In addition, when one of the images is acquired in advance, it follows a dynamic change in a situation where the heart moves at an irregular cycle such that the heart valve is caught once every two to three heartbeats. A superimposed image cannot be generated. On the other hand, in the present embodiment, since both the X-ray image and the medical image are acquired in real time, a superimposed image following a dynamic change can be generated.

  According to the present embodiment, the time difference is calculated based on the biological information attached to the X-ray image and the biological information attached to the medical image. Here, each attached biological information is information which is acquired in real time by one biological information acquisition means and shows a periodic change.

  Therefore, based on the common biological information acquired by one biological information acquisition means, the configuration for calculating the time difference between the X-ray image and the medical image, compared with the case of calculating the time difference based on different biological information, It is possible to improve the calculation accuracy of the time difference.

  Further, according to the present embodiment, since the biological information is an electrocardiogram waveform or a respiratory waveform, when calculating the time difference required for displaying an X-ray image and a medical image targeting an organ that moves according to heartbeat or respiration. The calculation accuracy can be improved.

  In addition, according to the present embodiment, since the medical image is an ultrasound image, the X-ray image acquired in real time and the ultrasound image can be superimposed to generate a superimposed image in time series. it can. For example, an angiographic X-ray image clearly includes contrast agent and catheter, but does not include a heart valve. Ultrasound images include contrast agents, catheters, and heart valves, but may be unclear and difficult to view. In the present embodiment, by superimposing such an X-ray image and an ultrasonic image, it is possible to generate a superimposed image that includes a contrast agent, a catheter, and a heart valve and is easy to visually recognize.

  In this embodiment, the example in which the superimposed image is generated by the processing circuit of the X-ray diagnostic apparatus has been described. However, the same effect can be obtained even when the superimposed image is generated by the processing circuit of the ultrasonic diagnostic apparatus. Can be obtained.

(Second Embodiment)
FIG. 5 is a block diagram illustrating a configuration example of the image processing apparatus 20 according to the second embodiment. The image processing apparatus 20 includes a communication interface circuit 21, an input interface circuit 22, a control circuit 23, a processing circuit 24, a buffer circuit 25, a storage circuit 26, and a display circuit 27.

  The communication interface circuit 21 is, for example, a circuit relating to a network, an X-ray diagnostic apparatus XR, an ultrasonic diagnostic apparatus UL, and an external storage device (not shown). The communication interface circuit 21 can receive an X-ray image from the X-ray diagnostic apparatus XR and can receive an ultrasonic image from the ultrasonic diagnostic apparatus UL. The communication interface circuit 21 receives an X-ray image from a CT apparatus performing CT fluoroscopy (Computed Tomography Fluoroscopy: CTF) instead of the X-ray diagnostic apparatus XR performing X-ray fluoroscopy or X-ray imaging. May be. Hereinafter, when information is exchanged via the communication interface circuit 21, the description “through the communication interface circuit 21” is omitted.

  The input interface circuit 22 captures various instructions, commands, information, selections, and settings from the operator into the image processing apparatus 20 or the processing circuit 24. The input interface circuit 22 is realized by a trackball, a switch button, a mouse, a keyboard, a touch pad that performs an input operation by touching an operation surface, and a touch panel display in which a display screen and a touch pad are integrated. The input interface circuit 22 is connected to the control circuit 23, converts the input operation received from the operator into an electrical signal, and outputs the electrical signal to the control circuit 23.

  In the present specification, the input interface circuit 22 is not limited to one having physical operation components such as a mouse and a keyboard. For example, an example of the input interface circuit 22 includes an electric signal processing circuit that receives an electric signal corresponding to an input operation from an external input device provided separately from the apparatus and outputs the electric signal to the control circuit 23. It is.

  The control circuit 23 is a processor that controls each circuit in the image processing apparatus 20. The control circuit 23 temporarily stores information such as an operator instruction input from the input interface circuit 22 in a memory (not shown). The control circuit 23 controls a superimposed image generation process in the processing circuit 24 in accordance with an operator instruction stored in the memory.

  The processing circuit 24 reads the control program stored in the storage circuit 26 in response to a start instruction input by the operator via the input interface circuit 22. The processing circuit 24 executes each function for generating a superimposed image in which an X-ray image and an ultrasonic image are superimposed according to the read control program. The above functions include, for example, a first acquisition function 24a, a second acquisition function 24b, a calculation function 24c, a buffer function 24d, and a superimposed image generation function 24e.

  The first acquisition function 24a is a function for acquiring an X-ray image of the subject in real time from the X-ray diagnostic apparatus XR that is the first modality. The X-ray image is associated with biological information of a subject using the X-ray diagnostic apparatus XR. The biological information corresponds to, for example, an electrocardiogram waveform or a respiratory waveform of the subject. The biological information is acquired by an electrocardiograph or a respiration sensor (not shown). The first acquisition function 24a outputs the acquired X-ray image to the buffer function 24d.

  The second acquisition function 24b is a function for acquiring in real time an ultrasonic image, which is a medical image of a subject, from the ultrasonic diagnostic apparatus UL that is a second modality different from the first modality. Specifically, the second acquisition function 24b acquires in real time an ultrasound image whose time series matches the X-ray image in parallel with the acquisition of the X-ray image by the first acquisition function 24a. The ultrasonic image is associated with biological information of the subject. The second acquisition function 24b outputs the acquired ultrasonic image to the superimposed image generation function 24e.

  Here, it is assumed that the X-ray image and the ultrasound image acquired both start image generation in a state in which phases related to biological information (for example, an electrocardiographic phase and a respiratory phase) coincide with each other. In addition, it is assumed that the biological information associated with the X-ray image and the ultrasound image is acquired from the same device (for example, an electrocardiograph or a respiration sensor).

  The calculation function 24c is a function for calculating a time difference between the time until the X-ray image is displayed on the display and the time until the ultrasonic image is displayed on the display, based on the biological information of the subject. . For example, the calculation function 24c calculates the time difference based on the biological information attached to the X-ray image and the biological information attached to the ultrasonic image. A specific example of the calculation method is the same as that of the calculation function 12c, and thus the description thereof is omitted.

  The buffer function 24d receives time difference information from the calculation function 24c, and outputs the X-ray image received from the first acquisition function 24a to the superimposed image generation function 24e after the time difference has elapsed. For example, the buffer function 24d stores the X-ray image in the buffer circuit 25, and outputs the X-ray image in the buffer circuit 25 after a time difference has elapsed. Note that the buffer function 24 d may store an X-ray image in a buffer area (not shown) in the storage circuit 26 instead of the buffer circuit 25.

  The superimposed image generation function 24e is a function that sequentially generates superimposed images by superimposing the X-ray image output from the buffer function 24d and the ultrasonic image output from the second acquisition function 24b. The phase of the X-ray image and the ultrasonic image received by the superimposed image generation function 24e is aligned by the buffer function 24d. Therefore, the superimposed image generation function 24e can generate a superimposed image without a time lag in superimposing the X-ray image and the ultrasonic image.

  The buffer circuit 25 is a storage circuit that temporarily stores an X-ray image. The buffer circuit 25 includes a memory for recording electrical information such as a semiconductor memory, and peripheral circuits such as a memory controller and a memory interface associated with the memory.

  The storage circuit 26 includes a memory that records electrical information such as an HDD (Hard Disk Drive), and peripheral circuits such as a memory controller and a memory interface associated with the memory. The memory is not limited to HDD, but SSD (solid state drive), magnetic disk (floppy (registered trademark) disk, hard disk, etc.), optical disk (CD, DVD, Blu-ray (registered trademark), etc.), semiconductor memory, etc. Can be used as appropriate.

  The storage circuit 26 stores the superimposed image generated by the processing circuit 24, the operator's instruction sent from the input interface circuit 10, and various data sent via the communication interface circuit 21 and the network. .

  The display circuit 27 includes a display that displays a medical image, an internal circuit that supplies a display signal to the display, and peripheral circuits such as a connector and a cable that connect the display and the internal circuit. The display displays the superimposed images sequentially generated by the processing circuit 24 as a moving image. The display may display a moving image by arranging at least one of an X-ray image and an ultrasonic image and a superimposed image.

  Next, the operation of the image processing apparatus 20 configured as described above will be described with reference to the flowchart of FIG. In the following description, the superimposed image generation processing by the processing circuit 24 will be mainly described. The superimposed image generation process is started by the operation of the operator.

  First, as described above, an electrocardiograph (not shown) acquires an electrocardiographic waveform of a subject and outputs the electrocardiographic waveform together with time information to the X-ray diagnostic apparatus XR and the ultrasonic diagnostic apparatus UL. To do.

  Similarly, the ultrasound diagnostic apparatus UL generates an ultrasound image based on the output of the transesophageal probe and attaches an electrocardiographic waveform and time information to the ultrasound image. Thereafter, the ultrasonic diagnostic apparatus UL transmits an ultrasonic image with an electrocardiographic waveform and time information attached to the image processing apparatus 20.

  The X-ray diagnostic apparatus XR sets an imaging condition of the subject by the operation of the operator, starts X-ray fluoroscopy or X-ray imaging of the subject, and sequentially generates X-ray images of the subject. The X-ray diagnostic apparatus XR transmits an X-ray image with an electrocardiographic waveform and time information attached to the image processing apparatus 20. In this state, the image processing apparatus 20 starts step ST1.

  In step ST1, the first acquisition function 24a acquires an X-ray image of the subject from the X-ray diagnostic apparatus XR in real time. The first acquisition function 24a outputs the acquired X-ray image to the buffer function 24d. The buffer function 24d stores the X-ray image in the buffer circuit 25.

  In step ST2, the second acquisition function 24b acquires the ultrasonic image of the subject from the ultrasonic diagnostic apparatus UL in real time in parallel with the acquisition of the X-ray image in step ST1. That is, step ST1 and step ST2 may be performed simultaneously.

  In step ST3, the calculation function 24c calculates a time difference Δt between the time until the X-ray image is displayed and the time until the ultrasound image is displayed based on the biological information of the subject.

  In step ST4, the buffer function 24d outputs the X-ray image in the buffer circuit 25 after the time difference Δt has elapsed.

  In step ST5, the superimposed image generation function 24e sequentially generates a superimposed image by superimposing the X-ray image output in step ST4 and the ultrasonic image acquired in step ST2.

  In step ST6, the display circuit 27 displays the superimposed images sequentially generated by the processing circuit 24 as moving images. After step ST6, the superimposed image generation process ends.

  As described above, according to the second embodiment, the same effects as those of the first embodiment can be obtained.

  In each of the above embodiments, the ultrasonic image may be a two-dimensional image or a three-dimensional image. Further, the processing after the calculation of the time difference by the calculation function may be performed at a predetermined time interval, or feedback may be used.

  The term “processor” used in the above description is, for example, a CPU, a GPU (Graphics Processing Unit), an application-specific integrated circuit (ASIC), a programmable logic device (for example, a simple programmable logic device (for example, It means circuits such as Simple Programmable Logic Device (SPLD), Complex Programmable Logic Device (CPLD), and Field Programmable Gate Array (FPGA).

  The processor implements various functions by reading and executing a program stored in the storage circuit. Instead of storing the program in the storage circuit, the program may be directly incorporated in the processor circuit. In this case, the processor implements various functions by reading and executing a program incorporated in the circuit.

  Each processor of the present embodiment is not limited to being configured as a single circuit for each processor, but is configured as a single processor by combining a plurality of independent circuits so as to realize various functions thereof. Also good. Furthermore, a plurality of components may be integrated into one processor to realize the function.

  The first acquisition function, the second acquisition function, the calculation function, the buffer function and the buffer circuit, the superimposed image generation function, and the display circuit in the first embodiment and the second embodiment are claimed. This is an example of a first acquisition unit, a second acquisition unit, a calculation unit, a buffer unit, a superimposed image generation unit, and a display unit in the range.

  Although several embodiments of the present invention have been described, these embodiments are presented by way of example 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 the equivalents thereof.

DESCRIPTION OF SYMBOLS 1 ... X-ray diagnostic apparatus, 2 ... X-ray high voltage apparatus, 3 ... X-ray tube, 4 ... X-ray detector, 5 ... Support frame, 6 ... Top plate, 7 ... Electrocardiograph, 8 ... Image generation circuit, 9, 21 ... communication interface circuit, 10, 22 ... input interface circuit, 11, 23 ... control circuit, 12, 24 ... processing circuit, 12a, 24a ... first acquisition function, 12b, 24b ... second acquisition function, 12c, 24c ... calculation function, 12d, 24d ... buffer function, 12e, 24e ... superimposed image generation function, 13, 25 ... buffer circuit, 14, 26 ... storage circuit, 15, 27 ... display circuit, 20 ... image processing device, EW1, EW2 ... electrocardiogram waveform, OL1, OL2 ... shaded portion, P ... subject, UL ... ultrasonic diagnostic apparatus, XR ... X-ray diagnostic apparatus.

Claims (7)

A first acquisition unit that acquires an X-ray image of the subject in real time;
In parallel with the acquisition of the X-ray image, a second acquisition unit that acquires the medical image of the subject from another modality in real time;
A calculation unit that calculates a time difference between the time until the X-ray image is displayed and the time until the medical image is displayed based on the biological information of the subject;
A buffer unit for outputting the X-ray image after the time difference has elapsed;
A superimposed image generation unit that sequentially generates a superimposed image in which the output X-ray image and the medical image are superimposed;
An X-ray diagnostic apparatus comprising: a display unit that displays the superimposed image. The calculation unit calculates the time difference based on biological information attached to the X-ray image and biological information attached to the medical image,
The X-ray diagnostic apparatus according to claim 1, wherein each of the attached biological information is information that is acquired in real time by one biological information acquisition unit and indicates a periodic change.   The X-ray diagnostic apparatus according to claim 1, wherein the display unit displays the acquired X-ray image in a region different from the superimposed image.   The X-ray diagnostic apparatus according to any one of claims 1 to 3, wherein the biological information is an electrocardiogram waveform or a respiratory waveform.   The X-ray diagnostic apparatus according to any one of claims 1 to 4, wherein the medical image is an ultrasound image. A first acquisition unit that acquires an X-ray image of the subject from the first modality in real time;
In parallel with the acquisition of the X-ray image, a second acquisition unit that acquires the medical image of the subject from the second modality in real time;
A calculation unit that calculates a time difference between the time until the X-ray image is displayed and the time until the medical image is displayed based on the biological information of the subject;
A buffer unit for outputting the X-ray image after the time difference has elapsed;
A superimposed image generation unit that sequentially generates a superimposed image in which the output X-ray image and the medical image are superimposed;
An image processing apparatus comprising: a display unit that displays the superimposed image. Means for acquiring an X-ray image of a subject in real time from a computer;
Means for acquiring the medical image of the subject in real time from another modality in parallel with the acquisition of the X-ray image;
Means for calculating a time difference between the time until the X-ray image is displayed and the time until the medical image is displayed based on the biological information of the subject;
Means for storing the acquired X-ray image in a storage circuit and outputting the X-ray image in the storage circuit after the time difference has elapsed;
A program for functioning as means for sequentially generating a superimposed image in which the outputted X-ray image and the medical image are superimposed.