JP4815341B2 - Medical X-ray equipment - Google Patents

Description

  The present invention relates to a medical X-ray imaging apparatus, and more particularly, in a medical X-ray imaging apparatus capable of at least CT imaging, or a medical X-ray imaging apparatus that can be shared with CT imaging and other panoramic imaging, cephalometric imaging, etc. The present invention relates to a medical X-ray imaging apparatus in which an imaging target area is positioned by beams emitted from a plurality of beam generators.

2. Description of the Related Art Conventionally, X-ray imaging apparatuses that perform panoramic imaging and CT imaging are known as medical X-ray imaging apparatuses used in medical departments and dentistry.
In particular, recently, medical X-ray imaging apparatuses capable of performing both panoramic imaging and CT imaging have been provided.
For example, a medical X-ray imaging apparatus used in dentistry, otolaryngology, and the like has an X-ray generator and an X-ray detector arranged to face each other, a turning arm that turns around a subject, and supports the turning arm, A lifting frame that moves up and down with the swivel arm with respect to the subject, and a subject head fixing means that fixes and holds the head of the subject at a predetermined position between the X-ray generator and the X-ray detector. The X-ray generator and X-ray detector are operated in accordance with the purpose of the subject head in accordance with the turning operation of the turning arm in a state where the head of the subject is fixed and held by the head fixing means. X-ray photography is performed.

Here, when the subject head is fixed and held at a predetermined position by the subject head fixing means, it is performed with reference to various positioning beams.
For example, at the time of panoramic shooting, the subject is irradiated from the front of the subject so that the midline beam for positioning the subject's head in the left-right direction matches the midline of the subject, The subject head is positioned such that the horizontal line beam for positioning the head in the vertical direction coincides with the line connecting the lower edge of the orbit of the subject or the lower nose point and the ear canal. Next, the swivel arm is swung so that the tomographic plane beam coincides with the tomographic reference position of the subject (for example, the position of the left canine), the panoramic imaging start point is positioned, the swivel arm is swung, and the panorama is swung. Shooting is performed.

Also, at the time of CT imaging, the subject's head is positioned in the same way as at the time of panoramic imaging, and a desired imaging region is irradiated with a tomographic plane beam or the like, or an approximate imaging target area is positioned, or panorama An imaging area is determined from the film or image data that has been imaged, positioning is performed, and CT imaging of a desired imaging region is performed.
When performing CT imaging over a relatively wide range, for example, CT imaging of the entire subject head, positioning of the imaging target area is not important, but in recent years, in order to reduce the amount of X-ray irradiation to the subject. In many cases, local CT imaging for CT imaging of only the local area inside the subject is used, and in this case, positioning of the imaging target area is important.

For example, in Patent Document 1, a patient frame provided with a chin rest that can be moved up and down on a support erected from a base, and a holding frame that can be moved up and down on the support independently of the patient frame, Curved tomography and flat surface provided with a swivel arm or the like that is suspended on the holding frame so as to be pivotable and movable in the horizontal plane direction, with an X-ray generator and an X-ray detector facing each other with the patient in between A medical X-ray imaging apparatus capable of tomography has been proposed.
In this device, the subject is introduced between the X-ray generator and the X-ray detector so as to face the support column, and the head is positioned by the midline beam and the horizontal beam as described above, and the tomographic plane Positioning of the imaging start point or imaging target area is performed by the beam, and irradiation is performed in the vicinity of the X-ray detector so as to extend along the horizontal direction to indicate the upper limit and the lower limit of the imaging range. Three beam generators provided in parallel are provided.
Thereby, it is possible to confirm in advance the range to be photographed before photographing.

Further, Patent Document 2 proposes a local irradiation X-ray imaging apparatus capable of accurately irradiating X-rays to a local site inside a human head.
As shown in FIG. 9, the local irradiation X-ray imaging apparatus described in Patent Document 2 includes an X-ray generator 1 and an X-ray detector 2 that face each other and a turning arm 3 that turns around a subject. An upper frame 4 that supports the swivel arm 3 so as to be rotatable about one axis, a pair of support columns 5 and 5 that support both base ends of the upper frame 4, and operations for displaying various operations and images provided on the support column 5 A panel 7, a subject is seated, and includes a head fixing means 8, a patient chair 9 equipped with an XY movement mechanism and an elevating mechanism.

Also, left and right guide beam generating means 6x (see FIG. 10B) provided on a support 4a extended from the upper frame 4 for positioning the subject in the left and right direction, and X-ray generation of the swivel arm 3 Front and rear guide beam generating means 6y and 6y, and upper and lower guide beam generating means 6z and 6z, which are provided in the vicinity of the detector 1 and the X-ray detector 2, respectively , for positioning in the front and rear direction and the vertical direction (FIG. 10C) (See (d)).
In this case, before actual photographing, as shown in FIG. 11A, the head of the subject is fixed by the subject fixing means 8, and the position of the root of the front tooth of the subject in the fixed state is set to each guide beam LX, The relative positions of the guide beam and the subject are moved so that LY and LZ (not shown) are irradiated, and they are positioned as actual photographing reference points, and the subject schematic diagram displayed on the operation panel 7 Calibration is performed so that the figure photographing reference point matches the actual photographing reference point.
In FIG. 11, a circle indicated by a broken line 3 a is a turning center of the turning arm 3, and the vicinity of the turning center is an actual local X-ray imaging region, which is also shown on the schematic diagram of the subject on the operation panel 7. In FIG. 11A, the intersection of each guide beam is directed to the turning center 3a.

As described above, when calibration for matching the schematic drawing photographing reference point and the actual photographing reference point is completed, the movement state of the subject is displayed on the operation panel 7 according to the movement of the relative position between the subject and the swivel arm 3. Reflected and displayed. The operator D operates the XY movement mechanism and the lifting mechanism of the patient chair 9 with the operation panel 7 so that the imaging region on the schematic diagram of the subject displayed on the operation panel 7 matches the desired imaging region. As shown in FIG. 11B, the subject is moved from the position P1 to P2, and the actual photographing is positioned.
As a result, the target local region can be imaged more reliably compared to the conventional method in which the imaging target region is estimated using only the guide beam irradiated from the outside.
JP-A-8-238238 JP 2002-315746 A

  However, in the medical X-ray imaging apparatus proposed in Patent Document 1, it is possible to confirm in advance the range captured before imaging by the guide beam indicating the upper limit and the lower limit of the captured range. The beam generators for the guide beam indicating the lower limit and the tomographic plane beam for positioning the imaging start point of the swivel arm are provided only at one end of the swivel arm (near the X-ray detector). If the swivel arm is at the initial position side, for example, the left side portion close to the X-ray detector side where each beam generator is provided, the amount of movement of the swivel arm for positioning the imaging target region is very small. When it is desired to photograph the side different from the initial position of the swivel arm, for example, the right part, the swivel arm is swung largely and the photographing target area is irradiated by the beam emitted from each beam generator. Should do positioning, there is a possibility of giving a sense of fear caused by the turning operation of the rotary arm relative to the subject.

Further, in the local irradiation X-ray imaging apparatus proposed in Patent Document 2, as described above, the actual imaging reference point and the schematic drawing imaging reference point are calibrated before actual imaging, thereby reliably Although it is possible to image a target local site, the operator can move the subject in the X-Y direction and up and down after calibration as well as the time and labor for calibration of the actual imaging reference point and the schematic drawing imaging reference point. Therefore, it is necessary to perform actual imaging positioning by moving the swivel arm 3 in the X-Y direction and in the vertical direction, which is time-consuming and time-consuming for the operator.
Moreover, in this thing, as mentioned above, it is set as the structure provided with a pair of support | pillars 5 and 5 which support both base end parts of the upper frame 4, The structure of a local irradiation X-ray imaging apparatus becomes a large-scale, It was necessary to take a large installation space.

  Furthermore, since the thing of the said patent document 1 is set as the structure which can perform CT imaging | photography with the conventional small panorama apparatus, it is not necessary to take a large installation space and can be installed also in a narrow X-ray imaging room, As described above, since the object is introduced between the X-ray generator and the X-ray detector so as to face the support column, the object is different from the initial position of the swivel arm as described above, for example, the right side. When the imaging target area is positioned by pivoting the swivel arm greatly when imaging the part, the operator's field of view is blocked by the support column, so the operator moves greatly and positions the imaging target area. It is necessary to hide the surgeon's appearance from the field of view of the subject when moving, for example, it becomes a shadow of a column or turns around from behind the subject, causing anxiety to the subject I'm afraid .

  The present invention has been proposed in order to solve the above-described problem. The first object of the present invention is to determine the amount of movement of the swivel arm when positioning the imaging target area with the beams emitted from a plurality of beam generators. An object of the present invention is to provide a medical X-ray imaging apparatus that reduces the above. A second object is to provide a medical X-ray imaging apparatus that reduces the amount of movement of the operator during positioning.

In order to achieve the above object, a medical X-ray imaging apparatus according to the present invention includes a swivel arm in which an X-ray generator and an X-ray detector are arranged opposite to each other with a subject interposed therebetween, and is moved relative to the subject. A medical X-ray imaging apparatus configured to position an imaging target area of a subject by beams emitted from a plurality of beam generators provided in a possible manner, wherein the plurality of beam generators includes the subject A left and right positioning beam generator for irradiating from the front direction and positioning in the left and right direction, and a pair of front and rear positioning beam generators for irradiating the subject from the left and right direction and positioning in the front and rear direction, beam irradiated from each is capable directed to pass through the imaging central axis, the pair of front and rear positioning beam generator, one beam generator the X-ray generator of the pivot arm In addition, the other beam generator is disposed on the X-ray detector side, and both beam generators are disposed at the same position as the X-rays emitted from the X-ray generator by the beams emitted from both beam generators. The beams satisfying the diagonal position relationship intersecting with each other, and the beams emitted from the both beam generators overlap with each other on the same plane in plan view, and are directed so as to be orthogonal to the beams emitted from the left and right positioning beam generators. It is characterized by.

In addition, a mirror is provided in the vicinity of at least one of the front and rear positioning beam generators, and the irradiation position of the beam irradiated from the one beam generator to the subject is adjusted by the mirror. It is also possible to make it visible through a mirror from the vicinity of the beam generator .
Further, in this case, the mirror surface of the mirror may be formed in a convex shape.

Still further, the swivel arm may be suspended from a support portion attached to a support column erected from a base, and may be configured to perform X-ray imaging with the subject facing the support column. .
The plurality of beam generators may be configured to be movable with respect to the subject.

According to the medical X-ray imaging apparatus of the present invention, the left and right positions that are irradiated from the front direction and positioned in the left and right directions are provided so as to be relatively movable with respect to the subject and can be directed so as to pass through the imaging center axis. The imaging target area can be easily positioned with the positioning beam and the front and rear positioning beams that are irradiated from the left and right directions and positioned in the front-rear direction. After positioning with each beam, the imaging is immediately performed without moving the swivel arm. Therefore, it is possible to reduce the fear of moving the swivel arm toward the subject.
In addition, this can reduce the time required from the positioning to imaging, which is convenient for both the surgeon and the subject.
In particular, since a pair of front and rear positioning beam generators are provided so as to sandwich the subject, positioning can be performed without swiveling the swivel arm when shooting any of the left and right parts of the subject, and turning to the subject. It is possible to reduce the feeling of fear due to the turning motion of the arm.

Furthermore, one of the pair of front and rear positioning beam generators is disposed on the X-ray generator side of the swivel arm, and the other is disposed on the X-ray detector side. beam emitted from both beams generator, since it is arranged such that a diagonal positional relationship that intersects the X-rays emitted from the X-ray generator, the beam emitted at the time of positioning, the pivot arm Since the object is irradiated in a state of being turned obliquely, at least one of the beams can be visually recognized without being blocked by the turning arm, and the visibility is improved.

A mirror is provided in the vicinity of at least one of the front / rear positioning beam generators, and the irradiation position of the beam irradiated from the one (front / rear positioning) beam generator to the subject is changed to the other ( Assuming that the beam generator can be seen through the mirror from the vicinity of the beam generator, the operator can irradiate the beam from the vicinity of the other beam generator through the mirror. The amount of movement of the operator can be reduced, and the installation space for the medical X-ray imaging apparatus does not need to be wide according to the amount of movement of the operator.
Further, since the amount of movement of the operator is reduced, it is possible to reduce the appearance of the operator from being hidden from view of the subject due to the movement, and there is no fear of giving anxiety to the subject.
Furthermore, in this case, if the mirror surface of the mirror is formed in a convex shape, the irradiation position of the beam projected on the mirror surface to the subject is not related to the height of the operator, From the vicinity of the front and rear positioning beam generator side, it can be confirmed through a mirror for convenience.

  If the swivel arm is hung on a support portion attached to a support column erected from a base, and the X-ray imaging is performed with the subject facing the support column, the patent Compared to what is described in Document 2, the configuration of the medical X-ray imaging apparatus does not increase in size and does not require a large installation space.

  Assuming that the plurality of beam generators are configured to be movable with respect to the subject, after the subject is positioned, the imaging target region is positioned by moving the beam generator side. Therefore, it is not necessary to move the subject to the actual shooting position, and it is possible to reduce giving anxiety to the subject.

Embodiments of the present invention will be described below with reference to the drawings.
1 to 8 show a medical X-ray imaging apparatus according to the present embodiment, FIG. 1 shows an example of a medical X-ray imaging apparatus according to the embodiment, (a) is a schematic front view, (B) is a schematic side view, FIG. 2 shows the internal structure of the two-dimensional moving means provided in the medical X-ray imaging apparatus according to the embodiment, (a) is a partially broken schematic side view, (b) ) Is a partially broken schematic plan view, FIG. 3 shows an example of a pair of front and rear positioning beam generators provided in the swivel arm of the medical X-ray imaging apparatus, and (a) is a schematic perspective view of the X-ray detector. FIG. 4B is a schematic perspective view of the X-ray generator, FIG. 4 shows an example of a left / right positioning beam generator included in the medical X-ray imaging apparatus, and FIG. 4A is a movement of the beam generator. FIG. 5 is a partially broken schematic plan view illustrating the mechanism, FIG. 5B is a partially broken schematic side view illustrating the moving mechanism of the beam generator, and FIG. a) is a schematic plan view schematically showing a state of positioning of a subject by beams emitted from a plurality of beam generators of the embodiment, and FIG. FIG. 6A is a schematic front view schematically showing an example of various beams, and FIG. 6A schematically shows a state when the imaging target area is positioned by the beams emitted from the plurality of beam generators of the embodiment (the left part of the subject). (B) is a schematic front view schematically showing an example of various beams irradiated to the subject's head in (a), and FIG. 7 (a) is a plurality of beams according to the embodiment. FIG. 7B is a schematic plan view schematically showing the state of the imaging target region when the imaging target region is positioned by the beam emitted from the generator (the right side portion of the subject), and FIG. 5B is an example of various beams emitted to the subject head in FIG. Schematic front view schematically showing Figure 8 is a partially cutaway side view showing another embodiment of a two-dimensional moving means in the medical X-ray imaging apparatus according to the embodiment.
In the present embodiment, a dental X-ray imaging apparatus is illustrated as an example, but the present invention is not limited to this, and the present invention can be applied to otolaryngology, ophthalmology, and other medical applications. .

A medical X-ray imaging apparatus A shown in FIG. 1 is capable of panoramic imaging and CT imaging. In general, a base 10 installed on the floor and a stand 10 on the base 10 are installed. And a lifting frame 12 that constitutes a support portion supported so as to be movable up and down with respect to the column 11 via a lifting mechanism (not shown), and a swivel arm 13 that is suspended by the lifting frame 12. ing.
The elevating frame 12 includes a frame side portion 12a supported so as to be movable up and down along the column 11, a frame lower side portion 12b extending from the lower end edge of the frame side portion 12a, and an upper end of the frame side portion 12a. With the frame upper side portion 12c extending from the edge, it is formed so that the side view is substantially C-shaped.

The frame side portion 12a is irradiated with a midline beam LI (see FIG. 5) from the front direction to the subject and positioned with the midline of the subject, and the midline of the subject. And a front mirror 12d provided so that the subject can be visually recognized when the beam and the mid beam LI coincide with each other, and a vertical positioning beam for irradiating the subject from the front direction to position the imaging target area in the vertical direction 14z is provided.
The beam irradiated from the vertical positioning beam generator 14z can also be used as a horizontal beam for positioning the subject head in the vertical direction as described above.

At the subject side end of the frame lower side 12b, a chin rest 12f that can be expanded and contracted vertically or tilted to constitute a subject head fixing means for fixing the head of the subject, and a temporal presser on both sides thereof. A pair of temporal pressing members 12e, 12e that can be moved to the left and right by the member adjusting knob 12h are provided, and a pair of gripping members 12g for gripping the subject on the subject-side back surface of the frame lower side 12b, 12g is provided.
The frame lower side 12b is provided with a left / right positioning beam generator 14x, which will be described later, in which the irradiation direction for irradiating the subject from the front direction and positioning in the left / right direction is movable in the left / right direction. ing.
A swivel arm 13 is swingably suspended in the vicinity of the subject side end of the frame upper side portion 12c, and the swivel arm 13, which will be described later, moves two-dimensionally in the horizontal plane area, that is, an XY move that moves the XY. The mechanism 20 (refer FIG. 2) is incorporated.

The swivel arm 13 is swingably suspended on the frame upper side portion 12c of the elevating frame 12 via a swivel center shaft 13d, which will be described later, and is formed in a reverse concave shape. The X-ray detector 13S (see FIG. 3 (a)) has an X-ray generator 13a containing the generator 13R (see FIG. 3 (b)) and the other side is opposed to the X-ray generator 13a. ) In the X-ray detector 13b.
On the outer side surface of the X-ray detection unit 13b (the other side when the side facing the X-ray generation unit 13a is the inner side surface, the same applies hereinafter), an operation panel 16 for displaying various settings of the imaging mode and images is provided. It has been.
Further, front and rear positioning beam generators 14ya and 14yb, which will be described later, are provided on one side portions 13aa and 13bb (see FIG. 3) of the X-ray generation unit 13a and the X-ray detection unit 13b, respectively.
Further, in the present embodiment, a side mirror (mirror) 17 to be described later is disposed on the inner side surface 13ac (see FIG. 3) of the X-ray generation unit 13a.
The turning center 13j (see FIG. 5) of the turning arm 13 and the X-ray detection surface 13bc (see FIG. 3) of the X-ray detector 13b are emitted from the X-ray source (X-ray generator 13R) of the X-ray generator 13a. In the case of local CT imaging, the turning center 13j is an imaging center axis, and its vicinity is an imaging region R (see R1, R2, and R3 in FIGS. 5 to 7, respectively). .

  The X-ray detector 13S can be constituted by a detection sensor such as a MOS sensor, a CMOS sensor, a TFT sensor, a CCD sensor, an X-ray solid-state imaging device, or a film cassette, and an X-ray generator 13R. For example, the X-ray beam irradiated from the X-ray tube is directed to the subject as a cone beam, a fan beam, a slit beam, etc. by changing the irradiation field by various slit shapes arranged in front of the X-ray tube. The structure etc. which irradiate can be applied, and other well-known ones can be applied.

Next, the XY movement mechanism 20 which comprises the two-dimensional movement means of the turning arm 13 is demonstrated based on FIG.
The XY moving mechanism 20 is built in the upper side housing 12ca of the frame upper side portion 12c of the elevating frame 12, and is fixed to the upper side housing 12ca, and also in the Y direction (front-rear direction, white in FIG. 1B). A pair of Y-direction guide rails 21y extending in the direction of the pulling arrow Y), a Y-direction moving frame 22y capable of reciprocating in the Y direction along these Y-direction guide rails 21y, A pair of X-direction guide rails 21x extending in the direction (left-right direction, white arrow X direction in FIG. 1A), and an X-direction moving frame 22x capable of reciprocating in the X direction along these X-direction guide rails 21x Have

The Y-direction moving frame 22y is screwed into a drive transmission mechanism suitable for the Y-direction moving motor 23y fixed to the upper side housing 12ca (for example, a screw shaft 24y drivingly connected to the Y-direction moving motor 23y). And a mechanism including a nut 25y fixed to the Y-direction moving frame 22y), and is configured to move in the Y direction based on driving of the Y-direction moving motor 23y.
Similarly, the X-direction moving frame 22x is connected to an X-direction moving motor 23x fixed to the Y-direction moving frame 22y by an appropriate drive transmission mechanism (for example, a screw shaft 24x drivingly connected to the X-direction moving motor 23x, and And a mechanism including a nut 25x fixed to the X-direction moving frame 22x) and is configured to move in the X direction based on driving of the X-direction moving motor 23x.

  Thus, in the XY moving mechanism 20 constituting the two-dimensional moving means, a pair of Y direction guide rails 21y, a Y direction moving frame 22y, a Y direction moving motor 23y, and a drive transmission mechanism thereof (screw shaft 24y, nut 25y). Etc.) constitutes a Y-direction movement mechanism, and a pair of X-direction guide rails 21x, an X-direction movement frame 22x, an X-direction movement motor 23x, and a drive transmission mechanism thereof (screw shaft 24x, nut 25x, etc.) It constitutes a moving mechanism.

A cylindrical or columnar turning center shaft 13d connecting the elevating frame 12 and the turning arm 13 has an upper end fixed to the X-direction moving frame 22x and a bearing (ball bearing) 13e built in the turning arm 13. Is supported rotatably.
Further, a circular belt winding portion (pulley) 13f whose cross section is concentric with the turning central shaft 13d is formed at the lower end portion of the turning central shaft 13d, and the belt 13g is attached to the belt winding portion 13f. It is wound.
The belt 13g is wound around another pulley (not shown) connected to a turning motor 13h fixed in the turning arm 13, and connects the belt winding portion 13f and the turning motor 13h. Based on the drive of the turning motor 13h, the turning arm 13 turns relative to the lifting frame 12 around a turning center axis 13d whose one end is fixed to the X-direction moving frame 22x of the lifting frame 12.

By driving the XY movement mechanism 20 configured as described above, that is, the X-direction movement motor 23x and the Y-direction movement motor 23y, the turning center axis 13d of the turning arm 13 is It is possible to move in the X-Y direction, and the swing arm 13 swings based on the drive of the swing motor 13h.
In addition, the structure of the revolving operation | movement of the XY moving mechanism 20 and the revolving arm 13 as mentioned above can apply the other well-known structure currently used with the dental panoramic X-ray imaging apparatus.

Next, the front and rear positioning beam generators 14ya and 14yb and the side mirror 17 will be described with reference to FIG.
The front / rear positioning beam generators 14ya, 14yb are for irradiating the subject from the left / right direction to position the imaging target area in the front / rear direction. The X-ray generators 13a, X-rays facing each other with the subject interposed therebetween. Each of the detectors 13b is disposed at a predetermined part.
In the present embodiment, the side portion 13aa at a position far from the column 11 of the X-ray generation unit 13a (in the state of FIG. 1 in which the turning arm 13 is not turning), and the side of the proximity position from the column 11 of the X-ray detection unit 13b. The diagonal position, ie, one front / rear positioning beam generator 14ya is on the X-ray generator 13R side of the swivel arm 13 and the other front / rear positioning beam generator 14yb is an X-ray detector. The beam generators 14Sa and 14yb are arranged on the side of the generator 13S. The positions of the beam generators 14ya and 14yb are determined by the beams LYa and LYb (see FIG. 5) irradiated from the beam generators 14ya and 14yb. Each beam LY emitted from both beam generators 14ya and 14yb is disposed so as to have a diagonal position relationship intersecting with the X-rays radiated from a and LYb are configured such that the irradiation direction of the subject moves in the Y direction (front-rear direction) by the XY movement mechanism 20 of the swivel arm 13.

The predetermined portion is not limited to the illustrated one, and the beams LYa and LYb (see FIG. 5) emitted from both the beam generators 14ya and 14yb correspond to the imaging central axis 13j, that is, the swivel arm 13. If it can be directed to pass through the turning center, and is directed so as to overlap on the same line in plan view, and can be directed to be orthogonal to a beam emitted from the left and right positioning beam generator 14x described later, For example, the rear surface of the upper side portion 13c of the swivel arm 13, the inner side surfaces 13ac and 13bc of the X-ray generation unit 13a and the X-ray detection unit 13b, or the side portions 13aa and 13bb, respectively. The structure is arranged so as to extend with an arm or the like at a position separated from the center, or opposite to the illustration, that is, the support of the X-ray generator 13a. And side 13ab proximity position from the 11 may be configured to contraposed in to diagonal positions so as to sandwich each subject and side 13ba far position from the support column 11 of the X-ray detector 13b.
Furthermore, it is good also as a structure arrange | positioned in the position which can irradiate each beam LYa and LYb along the X-ray radiated | emitted from X-ray generator 13R.

The side mirror 17 is located on the inner side surface 13ac of the X-ray generation unit 13a facing the X-ray detection surface 13bc of the X-ray detection unit 13b having the operation panel 16 disposed on the outer side, that is, in the vicinity of the front / rear positioning beam generator 14ya. The irradiation position of the beam LYa (see FIG. 5) irradiated from the front / rear positioning beam generator 14ya to the subject is determined from the vicinity of the other front / rear positioning beam generator 14yb at the time of positioning described later. D is configured to be visible through the side mirror 17 (see FIG. 5).
Further, the mirror surface of the side mirror 17 is formed in a convex shape so as to bulge toward the subject as shown in the figure.

In the present embodiment, the side mirror 17 is disposed on the substantially central position of the inner surface of the X-ray generator 13a, that is, on the optical path of X-rays emitted from the X-ray generator 13R toward the X-ray detector 13b. In this case, the side mirror 17 is preferably an X-ray transmission mirror such as a thin film aluminum, beryllium, or dichroic mirror that transmits X-rays and reflects visible light.
Further, arrangement設箇office side mirror 17 is not limited to the illustrated, the irradiation position of the beam of the object side surface mirror 17 is irradiated from one of the front and rear positioning beam generator provided near the other of the front and rear positioning From the vicinity of the beam generator side, it is only necessary that the operator D can be seen through the side mirror 17 at the time of positioning to be described later, and may be provided at a site that is not on the X-ray optical path. You may provide in the part 13a side, and you may apply other than what was further formed in convex shape.
Furthermore, in the side mirror 17 in the illustrated example, a part of the cylinder is vertically divided so that the visual field only in the vertical direction is widened, but a part of the sphere is formed so that the visual field in the vertical and horizontal directions is widened. It is good also as a shape cut out.

Next, the left and right positioning beam generator 14x will be described with reference to FIG.
The left / right positioning beam generator 14x irradiates the subject from the front direction to position the imaging target region in the left / right direction, and the irradiation direction changes in conjunction with the XY movement mechanism 20 of the swivel arm 13. The beam generator moving mechanism 40 is configured to be movable in the X direction (left-right direction).
The beam generator moving mechanism 40 is provided in the frame lower side portion 12 b of the elevating frame 12, a mounting plate 41 provided in the frame lower side portion 12 b, and a beam generator moving motor 42 fixed to the mounting plate 41. The screw shaft 44 connected to the beam generator moving motor 42 and disposed along the X direction, the guide shaft 45 disposed along the screw shaft 44, and the screw shaft 44 are threaded through. A moving block 46 having an insertion hole through which the female screw portion and the guide shaft 45 are inserted, a moving plate 47 in which an upper end portion is fixed to the moving block 46 and the left and right positioning beam generators 14x are arranged on the inclined portion, and a screw shaft 44 Further, both end portions of the guide shaft 45 are supported and the bearing portions 43 a and 43 b are fixed to the mounting plate 41.
Reference numeral 48 denotes a translucent plate formed of a translucent material that transmits the beam irradiated from the left and right positioning beam generator 14x.

In the beam generator moving mechanism 40 configured as described above, the beam generator moving motor 42 is driven in conjunction with the XY moving mechanism 20 of the swivel arm 13, and the screw shaft 44, The moving block 46, the moving plate 47, and the left and right positioning beam generator 14x are configured to move on the mounting plate 41 in the X direction along the guide shaft 45.
That is, in the present embodiment, the beam generators 14x, 14ya, and 14yb are configured to be movable with respect to the subject by the XY moving mechanism 20 and the beam generator moving mechanism 40.

  The XY movement mechanism 20 and the beam generator movement mechanism 40 may be configured to move at the same time, that is, to synchronize with each other. After the movement and positioning, the turning arm 13 may be moved by the XY movement mechanism 20. According to this, the movement amount of the turning arm 13 at the time of positioning before imaging can be reduced, and the fear of the patient before imaging can be reduced.

Further, the shape of the moving plate 47 is not limited to the one shown in the figure, and for example, the guide shaft 45 is not provided or provided, and the upper end portion is extended so that one side edge portion is elongated in the X direction. A structure in which the one side edge is movable so as to be supported by a guide member fixed to the mounting plate 41, or a roller is disposed on the lower end side, and moves along a guide rail formed on the mounting plate 41. It is good also as a possible structure.
Furthermore, instead of driving the screw shaft 44 by the beam generator moving motor 42, the moving block 46, the moving plate 47, and the left and right positioning beam generator 14x may be moved in the X direction via a pulley and a belt.
Furthermore, the arrangement positions of the left and right positioning beam generator 14x and the beam generator moving mechanism 40 are not limited to those in the illustrated example, and the XY moving mechanism of the swivel arm 13 such as the frame side portion 12a and the frame upper portion 12c. As long as the irradiation direction can be moved in the X direction (left and right direction) in conjunction with 20, and the front of the subject can be irradiated, any location may be used.

Although detailed description of the configuration of each of the beam generators 14, 14 x, 14 ya, 14 yb, and 14 z is omitted, the laser light oscillated from the laser light oscillation source that oscillates the visible light beam is expanded in the irradiation range. A concave lens and a configuration in which irradiation is performed in a horizontal or vertical direction through a cylindrical lens for irradiating the irradiation range widened by the concave lens as a planar beam, or a light source is a halogen lamp It is good also as a structure which is comprised with a LED, etc., and irradiates so that it may spread in the shape of a plane horizontally or vertically through the slit emission hole made into the elongate shape.
Furthermore, in the present embodiment, the midline beam generator 14 for irradiating the midline beam LI for positioning by aligning the midline of the subject, which will be described later, with the midline beam LI (see FIG. 5), generates the left and right positioning beams. Separately from the device 14x, it is configured to be fixedly disposed on the elevating frame 12. However, the right and left beams emitted from the left and right positioning beam generator 14x are also used as the mid beam without providing the mid beam generator 14. Also good.
Further, a left / right positioning beam generator 14x is fixedly disposed on the lower surface of the upper side portion 13c of the turning arm 13, and the subject is irradiated by XY movement of the turning arm 13 by the XY moving mechanism 20. The direction may be configured to move in the X direction (left-right direction).

Next, a procedure for positioning a subject and positioning an imaging target area in the medical X-ray imaging apparatus A having the above-described configuration will be described with reference to FIGS.
In FIGS. 5A to 7A, the shape of each component of the medical X-ray imaging apparatus A is not the same as the other figures, but each configuration of the medical X-ray imaging apparatus A The arrangement | positioning location of a member is shown typically.

First, when the subject P is fixedly held at a predetermined position, that is, positioned, the subject himself confirms the front mirror 12d with reference to the median beam LI irradiated from the median beam generator 14, and the midline And the midline beam LI coincide with each other, and the head of the subject P is fixed by the chin rest 12f, the side head pressing members 12e, 12e, and the like.
In this case, the vertical positioning beam LZ emitted from the vertical positioning beam generator 14z is further irradiated as a horizontal line beam for positioning the subject's head in the vertical direction, and the horizontal beam is below the orbit of the subject P. The subject head may be positioned so as to coincide with the line connecting the edge or the lower nose point and the ear canal.
In this case, especially in the case of local CT imaging, the chin rest 12f is adjusted up and down, and if it is desired to image a desired imaging region, for example, the upper jaw side, the chin rest 12f is moved downward to position the subject P. In this case, the vertical positioning beam LZ emitted from the vertical positioning beam generator 14z is emitted as a vertical positioning beam of the imaging target region.

In the positioning, the pair of front and rear positioning beam generators 14ya and 14yb may be operated to irradiate the left and right beams of the subject with the front and rear beams LYa and LYb.
According to this, since it is possible to confirm whether or not the front and rear beams LYa and LYb are respectively irradiated on the left and right symmetrical positions of the subject, it is possible to confirm whether or not there is a tilt to the left and right in the horizontal plane area of the subject head, The subject head can be positioned reliably.
In this case, when the side mirror 17 is provided as in the present embodiment, the operator D determines the irradiation position of the front and rear beam Lya irradiated from the front and rear positioning beam generator 14ya to the subject P as the front and rear positioning beam. This is convenient because it is visible from the vicinity of the generator 14yb without moving through the side mirror 17.
That is, the operator D can confirm the irradiation positions of the front and rear beams LYa and LYb irradiated from the pair of front and rear positioning beam generators 14ya and 14yb on the subject P without moving.

Further, in the present embodiment, the swing arm 13 is slightly bent from the position orthogonal to the lifting frame 12 so that the operator D can easily locate and observe each beam irradiated to the subject P during positioning. The position turned clockwise is the initial position.
That is, as in the present embodiment, the swivel arm 13 is suspended from a lifting frame 12 attached to a support column 11 erected from the base 10, and the subject P faces the support column 11 to perform X-ray imaging. In the case of the configuration, in order to reduce the installation space of the medical X-ray imaging apparatus A, it is preferable to shorten the extension length of the elevating frame 12 from the support column 11. Assuming that the position is orthogonal to the lifting frame 12, the field of view of the operator D is blocked by the lifting frame 12 and the support column 11, and therefore it is preferable that the swivel arm 13 is set to the initial position described above.
Accordingly, the operator D introduces the subject P between the X-ray generation unit 13a and the X-ray detection unit 13b of the imaging arm, that is, the X-ray detection unit 13b. For convenience, positioning can be performed with reference to FIG.
In this case, particularly in this embodiment, one front / rear positioning beam generator 14ya is on the X-ray generator 13R side of the swivel arm 13, and the other front / rear positioning beam generator 14yb is on the X-ray detector 13S side. The beam generators 14ya and 14yb are arranged at positions where the beams LYa and LYb irradiated from the beam generators 14ya and 14yb intersect with the X-rays emitted from the X-ray generator 13R. Since it is arranged so as to have an angular positional relationship, the operator D can easily see the irradiation position of each beam on the subject P without being blocked by the lifting frame 12 and the turning arm 13 as shown in the figure. It becomes.

Next, when performing CT imaging, the operation panel 16 is operated according to a desired imaging region inside the subject's head, the XY movement mechanism 20 is activated, and the swivel arm 13 with respect to the subject P is operated. Is moved XY to position the imaging target area.
In FIGS. 6B and 7B, the vertical positioning of the imaging target area is performed by adjusting the chin rest 12f as described above by adjusting the vertical positioning beam LZ emitted from the vertical positioning beam generator 14z. A state in which the upper jaw is irradiated as an imaging target region is shown.
The positioning of the imaging target area is performed with reference to the left and right beams LX emitted from the left and right positioning beam generators 14x and the front and rear beams LYa and LYb emitted from the front and rear positioning beam generators 14ya and 14yb.
In other words, when it is desired to image the local area of the left back side of the subject's head, as shown in FIG. 6, the operation panel 16 is operated to move the swivel arm 13 in the XY direction, and the XY movement. The beam generator moving mechanism 40 is operated in conjunction with the left and right beams LX irradiated from the left and right positioning beam generator 14x and the intersections of the front and rear beams Lya and LYb irradiated from the front and rear positioning beam generators 14ya and 14yb, that is, The shooting target area is positioned by moving on the subject P so that the shooting center axis 13j overlaps the shooting area R2.

On the other hand, when it is desired to photograph the right back part of the subject's head, as shown in FIG. 7, referring to the left and right beams LX and the front and rear beams LYa, the intersection of each beam, that is, the photographing center axis 13j. However, by operating the operation panel 16 so as to overlap the imaging region R3, the swivel arm 13 is moved XY as described above, and the beam generator moving mechanism 40 is operated in conjunction with the XY movement. Done.
At this time, the operator D can perform positioning while confirming the irradiation position of the front and rear beam LYa on the subject P with the side mirror 17.
That is, when the irradiation position of the front / rear beam LYa irradiated from the front / rear positioning beam generator 14ya provided on the side facing the X-ray detection unit 13b provided with the operation panel 16 is confirmed, the side mirror 17 is used. In the present embodiment, the operator D needs to largely avoid and move the support column 11 and the lifting frame 12, but in this embodiment, the operator D uses the side mirror 17 and the subject P of the front and rear beam LYa. By operating the operation panel 16 while confirming the irradiation position, the swivel arm 13 can be moved XY.

According to the positioning as described above, the operator D can set the desired imaging target area of the subject head without greatly displacing the swing arm 13 regardless of which part (the left part or the right part of the subject P). Positioning can be performed easily, and the amount of movement of the operator D can be reduced, so that the imaging target area can be positioned without giving fear or anxiety to the subject P.
That is, the surgeon D moves the swivel arm 13 to the initial position even when imaging a region where each beam generator is not provided, like the conventional medical X-ray imaging apparatus described in Patent Document 1. Therefore, it is possible to easily position the imaging target area without making a large turn, which is convenient for both the surgeon and the subject.
Further, since the mirror surface of the side mirror 17 is formed in a convex shape, the operator D can irradiate the subject P with the front and rear positioning beams regardless of the irradiation position of the subject P on the mirror P regardless of the height of the operator D. It can be confirmed through the mirror from the vicinity of the generator 14yb side for convenience.

Furthermore, since the movement amount of the operator D can be reduced, for example, there is no need to provide a space in consideration of the movement of the operator D between the support column 11 and one side wall of the X-ray imaging room 50, and medical X-ray imaging. It is not necessary to enlarge the X-ray imaging room 50 in which the apparatus A is installed in accordance with the movement of the operator D.
Furthermore, the swivel arm 13 is suspended by a lifting frame 12 attached to a support column 11 erected from the base 10 so that the subject P faces the support column 11 to perform X-ray imaging. Compared with what is described in Patent Document 2, the configuration of the medical X-ray imaging apparatus A is not increased in size and does not require a large installation space.
Further, since each beam generator 14x, 14ya, 14yb is configured to be movable with respect to the subject P, after the subject P is positioned, the beam generators 14x, 14ya, 14yb are moved. Since the shooting target area can be positioned, it is not necessary to move the subject P to the actual shooting position, and it is possible to reduce giving anxiety to the subject P.

The location of the operation panel 16 for operating the XY movement mechanism 20 is not limited to that shown in the figure, and may be provided on the frame side portion 12a of the elevating frame 12 or the side portion of the frame lower side portion 12b. Well, in the case where the side mirror 17 is provided as in the present embodiment, the X-ray provided with the side mirror 17 as in the present embodiment at the initial position of the swivel arm 13, that is, the opposite side position of the side mirror 17. Configuration provided on the outer side surface of the X-ray detection unit 13b facing the inner side surface of the generation unit 13a, or configuration provided on the side of the frame side portion 12a and the frame lower side portion 12b on the front side in FIG. It is preferable that
In the above description, the positioning at the time of CT imaging is mainly described as an example. However, at the time of panoramic imaging, the head of the subject is positioned as described above, and then the longitudinal positioning beam is irradiated as a tomographic plane beam. Then, it is possible to position the panorama shooting start point in accordance with the tomographic reference position, and other well-known swiveling operations at the time of panorama shooting of the swivel arm 13 can be applied.

  Further, in the present embodiment, the vertical positioning of the imaging target area is configured such that the subject P moves with respect to the vertical positioning beam LZ irradiated from the vertical positioning beam generator 14z by adjusting the chin rest 12f as described above. However, as in the front / rear positioning beam generators 14ya and 14yb, a vertical positioning beam generator 14z is provided at a predetermined portion of the swing arm 13, and the vertical positioning is performed in accordance with the vertical movement of the swing arm 13 by the lifting mechanism of the lift frame 12. A configuration in which the beam generator 14z is movable with respect to the subject P, or a patient frame that can be moved up and down with respect to a support as described in Patent Document 1, and a holding that is provided independently of the patient frame In the structure having the frame, the left and right by the beam generator moving mechanism 40 is arranged on the patient frame. Similar to the movement of the positioning beam generator 14x in the X direction, a beam generator moving mechanism for moving the vertical positioning beam generator 14z in the vertical direction (Z direction) is provided, and beam generation is performed in conjunction with the raising and lowering of the holding frame. It may be configured such that the vertical positioning beam generator 14z can be moved relative to the subject P by being moved up and down by a device moving mechanism.

Next, another aspect of the two-dimensional moving means will be described with reference to FIG.
In the example described above, the swivel arm 13 is configured to move XY relative to a subject positioned and fixed in a standing position. However, in this aspect, the subject chair 30 on which the subject sits on the medical X-ray imaging apparatus A is provided. In addition, the subject chair 30 has an XY movement mechanism 20A built therein.
Moreover, it is set as the structure further equipped with the Z moving mechanism which enables the displacement to a Z direction (up-down direction, white arrow Z direction).
In addition, about the member which has the same function as the above-mentioned, "'" is attached | subjected to the code | symbol, and detailed description is abbreviate | omitted.

The subject chair 30 includes a seating portion 31 on which a subject is seated, a back portion 32, an armrest 33, a footrest 34, a support portion 35, a base portion 36, a chin rest 12f ′ constituting a subject head fixing means, a head pressing member 12e ′, and the like. Is provided.
The XY moving mechanism 20A is fixed inside the base portion 36 and reciprocates in the X direction along a pair of X direction guide rails 21x ′ extending in the X direction (left and right direction) and the X direction guide rails 21x ′. Z direction moving frame 22x ', Z direction moving piston 22z that can reciprocate in the Z direction (vertical direction) and Z direction cylinder 21z fixed to X direction moving frame 22x', and Z direction movement A pair of Y-direction guide rails 21y ′ fixed to the piston 22z and extending in the Y direction (front-rear direction), and a Y-direction moving frame 22y ′ capable of reciprocating in the Y direction along the Y-direction guide rails 21y ′ Have

The X-direction moving frame 22x ′ is screwed into an appropriate drive transmission mechanism (for example, a screw shaft 24x ′ that is drivingly connected to the X-direction moving motor 23x ′ and the X-direction moving motor 23x ′ fixed to the base portion 36. And a mechanism including a nut 25x ′ fixed to the X-direction moving frame 22x ′), and is configured to move in the X direction based on driving of the X-direction moving motor 23x ′. .
Further, the Y-direction moving frame 22y ′ is connected to a Y-direction moving motor 23y ′ fixed to the Z-direction moving piston 22z with an appropriate drive transmission mechanism (for example, a screw shaft 24y ′ drivingly connected to the Y-direction moving motor 23y ′). And a mechanism including a nut 25y ′ fixed to the Y-direction moving frame 22y ′ and the like, and is moved in the Y direction based on the drive of the Y-direction moving motor 23y ′. It is configured.

Further, the Z-direction moving piston 22z of the Z-direction moving mechanism has an appropriate drive transmission mechanism (for example, a Z-direction moving motor 23z via a timing belt 26z) to a Z-direction moving motor 23z fixed to the X-direction moving frame 22x ′. And a screw shaft 24z that is drivingly connected to the screw shaft 24z and a mechanism that includes a nut 25z that is fixed to the Z-direction moving piston 22z. Configured to move in the direction.
In the XY movement mechanism 20A configured as described above, the subject itself is X with respect to the turning center axis 13d of the turning arm 13 by driving the X direction moving motor 23x ′ and the Y direction moving motor 23y ′. The swivel arm 13 is swiveled based on the drive of the swivel motor 13i.

When the XY movement mechanism 20A having the above-described configuration is applied to position the photographing target area, the above-described XY movement mechanism 20 is applied, that is, the revolving arm 13 is moved with respect to the subject P. In contrast, by moving the subject chair 30, that is, the subject P with respect to the turning arm 13, the relative positions of the beam generators 14x, 14ya, 14yb and the subject P can be moved, and the beam generators 14x , 14ya, 14yb, the target chair 30 is positioned by moving the subject chair 30 in the XY direction with reference to the beams LX, LYa, LYb.
Since the subject chair 30 includes the Z-direction moving mechanism, the lifting frame 12 may not include the lifting mechanism, and the chin rest 12f and the temporal pressing members 12e and 12e are not necessary. Of course.
It is also possible to apply the XY moving mechanism 20 described above together.

An example of embodiment of the medical X-ray imaging apparatus which concerns on this invention is shown, (a) is a schematic front view, (b) is a schematic side view. The internal structure of the two-dimensional movement means with which the medical X-ray imaging apparatus which concerns on the embodiment is provided is shown, (a) is a partially broken schematic side view, and (b) is a partially broken schematic plan view. 2 shows an example of a pair of front and rear positioning beam generators provided in a turning arm of the medical X-ray imaging apparatus, wherein (a) is a schematic perspective view of the X-ray detector, and (b) is a schematic perspective view of the X-ray generator. FIG. 1 shows an example of a left and right positioning beam generator provided in the medical X-ray imaging apparatus, wherein (a) is a partially broken schematic plan view illustrating a moving mechanism of the beam generator, and (b) is the beam generator. It is a partially broken schematic side view explaining the moving mechanism. (A) is a schematic plan view schematically showing a state of positioning of a subject by beams emitted from a plurality of beam generators of the embodiment, and (b) is a diagram showing a subject head irradiated in (a). It is a schematic front view which shows typically an example of various beams. (A) is a schematic plan view schematically showing a state at the time of positioning of an imaging target region (beam on the left side of the subject) by beams emitted from a plurality of beam generators of the embodiment, and (b) is a diagram (a). FIG. 2 is a schematic front view schematically showing an example of various beams emitted to the subject's head in FIG. (A) is a schematic plan view schematically showing a state at the time of positioning of an imaging target area (a right side portion of the subject) by beams emitted from a plurality of beam generators of the embodiment, and (b) is a diagram (a). FIG. 2 is a schematic front view schematically showing an example of various beams emitted to the subject's head in FIG. It is a partially broken side view which shows the other aspect of the two-dimensional movement means in the medical X-ray imaging apparatus which concerns on the embodiment. It is a schematic front view which shows the conventional medical X-ray imaging apparatus. (A) thru | or (d) are all perspective views which show the beam irradiated from the various guide beam generation means with which the conventional medical X-ray imaging apparatus is provided. 1 schematically shows front and rear guide beams and left and right guide beams emitted from a conventional medical X-ray imaging apparatus. (A) is a schematic plan view showing the position of the subject before photographing, and (b) is a schematic plan view showing the relationship between the subject at the time of actual photographing and the swivel arm.

Explanation of symbols

10 base 11 support 12 lifting frame (support)
DESCRIPTION OF SYMBOLS 13 Rotating arm 13a X-ray generation part 13b X-ray detection part 13j Imaging center axis 13R X-ray generator 13S X-ray detector 14x Left-right positioning beam generator 14ya, 14yb Front-rear positioning beam generator 17 Side mirror (mirror)
A Medical X-ray equipment P Subject

Claims (5)

A swivel arm in which an X-ray generator and an X-ray detector are arranged to face each other with a subject interposed therebetween,
A medical X-ray imaging apparatus configured to position an imaging target area of a subject by beams emitted from a plurality of beam generators provided so as to be relatively movable with respect to the subject,
The plurality of beam generators include:
A left / right positioning beam generator that irradiates the subject from the front direction and performs left / right positioning, and a pair of front / rear positioning beam generators that irradiate the subject from the left / right direction and perform front / rear positioning. It is possible to direct the beam irradiated from each through the shooting center axis,
The pair of front and rear positioning beam generators are:
One beam generator is disposed on the X-ray generator side of the swivel arm, and the other beam generator is disposed on the X-ray detector side.
The arrangement positions of both beam generators satisfy a diagonal positional relationship in which the beams emitted from both beam generators intersect with the X-rays emitted from the X-ray generator, and
The medical X is characterized in that the beams irradiated from both the beam generators overlap with each other in a plan view and are directed so as to be orthogonal to the beams irradiated from the left and right positioning beam generators. X-ray equipment. In claim 1,
A mirror is provided in the vicinity of at least one of the front and rear positioning beam generators, and the irradiation position of the beam irradiated from the one beam generator to the subject is determined by the mirror. A medical X-ray imaging apparatus characterized by being visible through a mirror from the vicinity of a generator . In claim 2,
A medical X-ray imaging apparatus, wherein a mirror surface of the mirror is formed in a convex shape . In any one of Claims 1 thru | or 3,
The swivel arm is suspended on a support portion attached to a support column erected from a base,
A medical X-ray imaging apparatus configured to perform X-ray imaging with the subject facing the support . In any one of Claims 1 thru | or 4,
The medical X-ray imaging apparatus, wherein the plurality of beam generators are configured to be movable with respect to the subject .

Images