JP6147716B2 - Diagnosis support apparatus, diagnosis support method, and diagnosis support program - Google Patents

Description

  The present invention relates to a diagnosis support apparatus, a diagnosis support method, and a diagnosis support program, and in particular, acquires an MRI image (tomographic image) from a tomographic imaging apparatus such as a breast MRI (Magnetic Resonance Imaging) apparatus that images a breast tomogram. The present invention relates to a diagnosis support apparatus, a diagnosis support method, and a diagnosis support program for diagnosing an affected area such as a breast.

  Breast cancer imaging methods include mammography, ultrasound, and MRI. Among these, the mammography method and the ultrasound method are used for breast cancer screening as well as visual inspection. On the other hand, the MRI system may not be recommended for breast cancer screening because contrast agents may be used for the examination ("Breast MRI screening guidelines for breast cancer onset high risk group Ver.1.0" Japan Breast Cancer Screening Society 2012).

  However, the usefulness of breast MRI has been widely recognized overseas as a diagnostic purpose to examine the degree of progression and spread of cancer. Although it has not been recognized in Japan due to lack of evidence, In 2013, it was designated as Grade B (“Evidence (effective evidence / evidence) is recommended and recommended to be practiced in daily practice”) in the Breast Cancer Practice Guidelines of the Japan Breast Cancer Society. It came to be recognized.

  In addition, as awareness of usefulness spreads, the guidelines for breast MRI examination “BI-RADS-MRI”, which was born in the United States, have attracted attention. Currently, examination methods and interpretation based on the Japanese version of BI-RADS-MRI Methods and report description methods have been adopted by many facilities.

  One of the contents of the diagnostic report recommended by this BI-RADS-MRI is the item “Kinetic curve assessment, Signal intensity / time curve description”, which includes “Initial phase” and “Delayed phase”. It is recommended that a phase This examination for evaluation is called dynamic MR mammography.

  Note that the injection start time of the contrast medium is “T0”, the time when 60 to 120 seconds have elapsed from the time T0 is “T1”, and the time when 300 to 420 seconds have elapsed from the time T1 is “Tn”. The time phase from time T0 to time T1 corresponds to the “initial phase”, and the time phase from time T1 to time Tn corresponds to the “delay phase”. In addition, the signal strength change characteristics in the initial phase are classified into “Slow”, “Medium”, and “Fast”, and the signal strength change characteristics in the delayed phase are “Persistent”, “Plateau”, “Washout”. There are three categories.

Nakahara Hiroshi, “Breast MRI Diagnosis Using CAE”, Breast Cancer BOOK 2014, RadFan July 2014 Special Issue, p. 79-p. 81 Aze, Inc., “MRI Breast Cancer Analysis Software Diagnosed from Perfusion”, Monthly Inner Vision August 2014 issue, p. 77

  In order to perform interpretation in accordance with BI-RADS-MRI in breast MRI examination, it is ideal that the change characteristics of the signal intensity in each of the initial phase and the delayed phase can be easily and simultaneously evaluated in Kinetic curve assessment.

  However, at present, Kinetic curve assessment is performed by the conventional Time Intensity Curve measurement, so the measurement takes time and is not convenient. In addition, although there is an application that makes color intensity mapping using the amount or rate of change in signal intensity (pixel value) for each pixel that forms a tomographic image, and simplifies Time Intensity Curve measurement, the initial phase and the delayed phase are evaluated simultaneously. Difficult to do. As a result, at present, there is a limit in convenience when diagnosing the affected area.

  Therefore, a main object of the present invention is to provide a diagnosis support apparatus, a diagnosis support method, and a diagnosis support program, which can improve convenience when diagnosing an affected area.

  In the diagnosis support apparatus according to the present invention (10: reference numeral corresponding to the embodiment, the same applies hereinafter), each pixel represents a color corresponding to one of a plurality of first time phase characteristics (Fast, Medium, Slow). First color map creating means (S7) for creating the first color map based on the first tomographic image corresponding to the first time phase and representing the tomographic lesion, and a plurality of second time phase characteristics (Persistent, Plateau, Washout ), A second color map creating means (S9) that creates a second color map in which each pixel represents a color corresponding to any one of the above, based on a second tomographic image corresponding to the second time phase and representing a tomogram of the affected area. ), First receiving means (S65) for repeatedly receiving a first selection operation for selecting a first time phase characteristic whose visualization should be restricted from among a plurality of first time phase characteristics, a first selection selected by the first selection operation The first modified color map (MP01) from which the color corresponding to the temporal characteristics is excluded is the first color map. First modified color map display means (S67, S39, S49) for displaying based on the first color map created by the pop creating means, and on the first modified color map displayed by the first modified color map display means Based on the second color map created by the second color map creating means, the second modified color map from which the color outside the second region (R2) common to the first region (R1) where the color appears is excluded. Second modified color map display means (S41 to S49).

  Preferably, the first correction color map display means and the second correction color map display means execute processing in parallel with each other, and the first reception means is processing of the first correction color map display means and the second correction color map display means. The first selection operation is accepted in parallel with the.

  Preferably, second receiving means (S71) for receiving a second selection operation for selecting a second time phase characteristic whose visualization should be restricted from a plurality of second time phase characteristics, and the second selection means selected by the second selection operation. There is further provided color exclusion means (S73, S75) for excluding the color corresponding to the two temporal characteristics from the second corrected color map to be displayed by the second corrected color map display means.

  Preferably, a graph display means (S55) is further provided for displaying a graph representing a temporal change of the pixel value at a desired position on the tomogram based on the first tomographic image and the second tomographic image.

  In one aspect, the first modified color displayed by the first modified color map display unit and the second modified color map display unit respectively, with the first pointer and the second pointer commonly pointing to a desired position according to the pointer moving operation. Pointer multiplexing means (S51, S59, S61) for multiplexing the map and the second modified color map are further provided.

  In another aspect, graph display restriction means (S53, S57) is further provided for restricting the processing of the graph display means when a desired position corresponds to a position outside the second region.

  In other aspects, time and pixel values are assigned to the horizontal and vertical axes of the graph, respectively, and color bars indicating a plurality of colors respectively corresponding to a plurality of first time phase characteristics are displayed along the vertical axis of the graph. Color bar display means (S17) is further provided.

  Preferably, first representative image display means (S3, S21, S37) for displaying a first representative image representing the first time phase based on the first tomographic image, and a second representative image representing the second time phase Is further provided with second representative image display means (S5, S21, S37) for displaying the first representative image displayed by the first representative image display means. The second correction color map display means multiplexes the second correction color map on the second representative image displayed by the second representative image display means.

  The diagnosis support method according to the present invention is a diagnosis support method executed by the processor (14) of the diagnosis support apparatus (10), and includes any one of a plurality of first time phase characteristics (Fast, Medium, Slow). A first color map creating step (S7) for creating a first color map representing a corresponding color by each pixel based on a first tomographic image corresponding to a first time phase and representing a tomogram of an affected area, a plurality of second times A second color map in which each pixel represents a color corresponding to any one of phase characteristics (Persistent, Plateau, Washout) is created based on a second tomographic image corresponding to the second time phase and representing a tomographic lesion A second color map creation step (S9), a first reception step (S65) for repeatedly receiving a first selection operation for selecting a first time phase characteristic whose visualization should be restricted from a plurality of first time phase characteristics, The color corresponding to the first time phase characteristic selected by the selection operation is excluded. A first corrected color map display step (S67, S39, S49) for displaying the first corrected color map (MP01) obtained based on the first color map generated by the first color map generating step, and a first corrected color The second modified color map in which the color outside the second region (R2) common to the first region (R1) where the color appears on the first modified color map displayed by the map display step is excluded is the second color. A second corrected color map display step (S41 to S49) for displaying based on the second color map created by the map creating step is provided.

  In the diagnosis support program according to the present invention, each pixel represents a color corresponding to any one of a plurality of first time phase characteristics (Fast, Medium, Slow) in the processor (14) of the diagnosis support apparatus (10). A first color map creating step (S7) for creating one color map based on a first tomographic image corresponding to the first time phase and representing a tomographic lesion, and a plurality of second time phase characteristics (Persistent, Plateau, Washout) A second color map creating step (S9) for creating a second color map in which each pixel represents a color corresponding to any one of the above based on a second tomographic image corresponding to the second time phase and representing a tomogram of the affected area First reception step (S65) for repeatedly receiving a first selection operation for selecting a first time phase characteristic whose visualization should be restricted from among a plurality of first time phase characteristics, and a first time selected by the first selection operation The first modified color map (MP01) in which the color corresponding to the phase characteristic is excluded A first modified color map display step (S67, S39, S49) for displaying based on the first color map created by the first color map creating step, and a first modified color displayed by the first modified color map display step The second color map created by the second color map creating step is the second modified color map in which the color outside the second area (R2) common to the first area (R1) where the color appears on the map is excluded. This is a diagnosis support program for executing the second corrected color map display step (S41 to S49) to be displayed based on the above.

  The first color map is a map in which each pixel represents a color corresponding to one of a plurality of first time phase characteristics, and the second color map is also one of a plurality of second time phase characteristics for each pixel. It is a map showing the color corresponding to.

  When the first time phase characteristic whose visualization is to be limited is selected by the first selection operation, the first modified color map from which the color corresponding to the selected first time phase characteristic is excluded is displayed based on the first color map. Then, the second corrected color map in which the color outside the second area common to the first area where the color appears on the first corrected color map is excluded is displayed based on the second color map.

  Therefore, when the first temporal characteristic for which visualization is to be restricted is changed by the first selection operation, the expression mode of the first correction color map changes, and further the expression mode of the second correction color map changes. This improves convenience when diagnosing the affected area.

  The above object, other objects, features and advantages of the present invention will become more apparent from the following detailed description of embodiments with reference to the drawings.

It is a block diagram which shows an example of a structure of the medical diagnosis assistance system applied to this Example. (A) is an illustrative view showing an example of the structure of 200 DICOM (Digital Imaging and Communication in Medicine) files each containing 200 slice MRI images collected at time T0, and (B) is at time T1. It is an illustration figure which shows an example of the structure of 200 DICOM files each containing the acquired 200-slice MRI image, (C) is 200 pieces each containing the 200-slice MRI image acquired at the time T2. It is an illustration figure which shows an example of the structure of a DICOM file, (D) is an illustration figure which shows an example of the structure of 200 DICOM files each containing the 200 slice MRI image collected at the time T3, (E ) Shows an example of the structure of 200 DICOM files each containing 200 slice MRI images collected at time Tn. It is an illustrative view. (A) is an illustrative view showing an example of a complementary image representing the initial phase created by performing a complementary process on the MRI image at the head slice position, and (B) is a process for performing the complementary process on the MRI image at the head slice position. It is an illustration figure which shows an example of the complementary image representative of the delay phase produced in this way. (A) is an illustrative view showing an example of a complementary image representing an initial phase created by performing a complementary process on an MRI image at a desired slice position, and (B) is a complementary process on an MRI image at a desired slice position. It is an illustration figure which shows an example of the complementary image which represents the delay phase produced by giving. (A) is an illustrative view showing an example of an initial phase color map based on the complementary image shown in FIG. 3 (A) and corresponding to the time phase characteristic of “Fast”, and (B) is shown in FIG. 3 (A). FIG. 4C is an illustrative view showing an example of an initial phase color map based on a complementary image and corresponding to a time phase characteristic of “Medium”, and (C) is a time phase of “Slow” based on the complementary image shown in FIG. FIG. 4D is an illustrative view showing one example of an initial phase color map corresponding to characteristics, and FIG. 3D is an example of a delayed phase color map corresponding to the time phase characteristics of “Persistent” based on the complementary image shown in FIG. (E) is an illustrative view showing an example of a delayed phase color map based on the complementary image shown in FIG. 3 (B) and corresponding to the time phase characteristic of “Plateau”, and (F) is a diagram. Delayed phase color based on the complementary image shown in 3 (B) and corresponding to the time phase characteristics of “Washout” Tsu is an illustrative view showing one example of a flop. FIG. 4A is an illustrative view showing an example of an initial phase color map based on the complementary image shown in FIG. 4A and corresponding to the time phase characteristic of “Fast”, and FIG. 4B shows the initial phase color map. It is an illustration figure which shows an example of the initial phase color map based on a complementary image and corresponding to the temporal characteristic of "Medium", (C) is based on the complementary image shown in FIG. 4 (A), and is a time phase of "Slow" FIG. 5D is an illustrative view showing an example of an initial phase color map corresponding to a characteristic, and FIG. 4D is an example of a delayed phase color map corresponding to a temporal characteristic of “Persistent” based on the complementary image shown in FIG. 4E is an illustrative view showing an example of a delayed phase color map based on the complementary image shown in FIG. 4B and corresponding to the time phase characteristic of “Plateau”, and FIG. Delayed phase color based on complementary image shown in 4 (B) and corresponding to “Washout” temporal characteristics Tsu is an illustrative view showing one example of a flop. It is an illustration figure which shows an example of the diagnostic image displayed on the display apparatus provided in the diagnostic assistance apparatus of this Example. It is an illustration figure which shows another example of the diagnostic image displayed on the display apparatus provided in the diagnostic assistance apparatus of this Example. It is a graph which shows an example of the time change in the initial phase of the value of the pixel designated by the pointer. It is a graph which shows an example of the time change in the initial phase and delay phase of the value of the pixel designated by the pointer. It is a graph which shows another example of the time change in the initial phase and delay phase of the value of the pixel designated by the pointer. It is a graph which shows another example of the time change in the initial phase of the pixel value designated by the pointer, and a delay phase. An example of two MRI images respectively corresponding to an initial phase and a delayed phase, an initial phase color map and a delayed phase color map multiplexed thereon, and color mode information representing a current initial phase color mode and a delayed phase color mode It is an illustration figure shown. Two MRI images corresponding respectively to the initial phase and the delayed phase, the initial phase color map and the delayed phase color map multiplexed thereon, and other color mode information representing the current initial phase color mode and the delayed phase color mode It is an illustration figure which shows an example. (A) is an illustrative view showing an example of an assignment state of a region R1 in an initial phase color map, and (B) is an illustrative view showing an example of an assignment state of a region R2 in a delayed phase color map. It is an illustration figure which shows an example of the delay phase color map multiplexedly displayed on the MRI image according to the delay phase color mode after a change. Two MRI images corresponding respectively to the initial phase and the delayed phase, the initial phase color map and the delayed phase color map multiplexed thereon, and other color mode information representing the current initial phase color mode and the delayed phase color mode It is an illustration figure which shows an example. Two MRI images corresponding to the initial phase and the delayed phase respectively, the initial phase color map and the delayed phase color map multiplexed thereon, and other color mode information indicating the current initial phase color mode and the delayed phase color mode It is an illustration figure which shows an example. It is a flowchart which shows a part of operation | movement of CPU provided in the diagnostic assistance apparatus of this Example. It is a flowchart which shows a part of other operation | movement of CPU provided in the diagnostic assistance apparatus of this Example. It is a flowchart which shows a part of other operation | movement of CPU provided in the diagnostic assistance apparatus of this Example. It is a flowchart which shows further another part of operation | movement of CPU provided in the diagnosis assistance apparatus of this Example. It is a flowchart which shows a part of other operation | movement of CPU provided in the diagnostic assistance apparatus of this Example.

  With reference to FIG. 1, the medical diagnosis support system of this embodiment is configured by a diagnosis support apparatus 10 and an MRI apparatus 30 connected to each other via a communication network 40. In the diagnosis support apparatus 10, a communication I / F 12, a CPU 14, a keyboard 16, a mouse 18, a display device 20, a DRAM 22, and a main storage device 24 are connected to the bus BS1. The display device 20 is provided with a screen SCR.

  The MRI apparatus 30 is an apparatus that creates an MRI image of a patient's breast using a nuclear magnetic resonance phenomenon. Imaging is performed once before the contrast agent is injected into the breast (this is referred to as “plane imaging”), and once the contrast agent injection is started, it is performed four times at a rate of once every 60 seconds. The If the injection start time of the contrast medium is defined as “T0”, the four imaging times that come every 60 seconds thereafter are defined as “T1”, “T2”, “T3”, and “Tn”, respectively.

  Note that each imaging takes several seconds, and each of the times T0 to Tn strictly indicates an imaging start time. Further, in this embodiment, it is assumed that the contrast medium injection start time coincides with the plane imaging time, and the time T0 is also the plane imaging time. Furthermore, the time phase from time T0 to time T1 is called “initial phase”, and the time phase from time T1 to time Tn is called “delayed phase”.

  In the MRI apparatus 30, 200 frames of MRI images F0 to F199 respectively corresponding to 200 different slice positions P0 to P199 are created at times T0 to Tn. The value (= signal intensity) of each pixel forming the created MRI image reflects the concentration of the contrast agent flowing through the slice at the slice position during imaging, that is, the blood concentration.

  The MRI apparatus 30 stores the MRI image thus created in a DICOM file together with the file size, patient information, imaging time, and slice position. The imaging time is managed by a tag of collection time (0008, 0032) defined by the DICOM standard.

  As a result, 200 DICOM files shown in FIG. 2A are created at time T0, 200 DICOM files shown in FIG. 2B are created at time T1, and FIG. 2C is created at time T2. The 200 DICOM files shown are created. At time T3, 200 DICOM files shown in FIG. 2D are created, and at time Tn, 200 DICOM files shown in FIG. 2E are created.

  The communication I / F 12 provided in the diagnosis support apparatus 10 acquires a total of 1000 DICOM files created in this way from the diagnosis support apparatus 10 through the communication network 40. The acquired DICOM file is stored in the main storage device 24 via the bus BS1.

  The DICOM file may be managed by an external server (not shown). In this case, the diagnosis support apparatus 10 acquires a desired DICOM file from an external server at a desired timing.

  The CPU 14 executes processing according to the flowcharts shown in FIGS. 19 to 23 in order to display a diagnostic image on the screen SCR of the display device 20 based on the DICOM file stored in the main storage device 24. A program corresponding to this flowchart is stored in the main storage device 24 as a diagnosis support program.

  First, a variable K for identifying a slice position is set to “0” in step S1. In step S3, an MRI image representing a slice at the slice position PK at each of the times T0 and T1 is transferred from the main storage device 24 to the DRAM 22, and a complementary process is performed on the transferred two frames of the MRI image to create a complementary image IM01. To do. The created complementary image IM01 corresponds to a representative image representing the initial phase.

  In step S5, the MRI image representing the slice at the slice position PK at each of the times T1 to Tn is transferred from the main storage device 24 to the DRAM 22, and the complemented processing is performed on the transferred four-frame MRI image to create the complementary image IM1n. To do. The created complementary image IM1n corresponds to a representative image representing the delayed phase.

  In step S7, initial phase color maps MP01fst, MP01md, and MP01slw corresponding to the slice position PK are created based on the two-frame MRI image transferred to the DRAM 22 in step S3. In step S9, delay phase color maps MP1npst, MP1nplt, and MP1nwsh corresponding to the slice position PK are created based on the four-frame MRI image transferred to the DRAM 22 in step S7.

  According to BI-RADS-MRI, the temporal changes of pixel values in the initial phase, that is, the initial phase characteristics, are classified into three categories, “Fast”, “Medium”, and “Slow”. The mode of change, that is, the delayed phase characteristic, is classified into three types, “Persistent”, “Plateau”, and “Washout”.

  The initial phase color map MP01fst corresponds to a map in which the pixels indicating “Fast” are colored, the initial phase color map MP01md corresponds to a map in which the pixels indicating “Medium” are colored, and the initial phase color map MP01slw is “Slow”. It corresponds to a map in which the pixels indicating "" are colored.

  The delay phase color map MP1npst corresponds to a map in which pixels indicating “Persistent” are colored, the delay phase color map MP1nplt corresponds to a map in which pixels indicating “Plateau” are colored, and the delay phase color map MP1nwsh is This corresponds to a map in which pixels indicating “Washout” are colored.

  In any of the initial phase color maps MP01fst, MP01md, MP01slw and the delayed phase color maps MP1npst, MP1nplt, MP1nwsh, the color assigned to the target pixel differs depending on the value of the target pixel.

  In step S11, it is determined whether or not the variable K has reached “199”. If the determination result is NO, the variable K is incremented in step S13 and then the process returns to step S3. Proceed to S15. Therefore, the processes in steps S3 to S9 are repeated 200 times.

  As a result, complementary images IM01 and IM1n are created corresponding to each of the slice positions P0 to P199, and the initial phase color maps MP01fst, MP01md, MP01slw and the delayed phase color maps MP1npst, MP1nplt, MP1nwsh are the slice positions P0 to P199. Created for each.

  In step S15, a frame of the graph is drawn on the DRAM 22, and the display device 20 is requested to display the frame. In step S17, a color bar is drawn on the DRAM 22, and the display device 20 is requested to display the color bar.

  The display device 20 reads the frame and color bar of the graph from the DRAM 22 and displays the read frame and color bar on the upper stage of the screen SCR in the manner shown in FIG. According to FIG. 7, the graph frame is displayed in the upper center of the screen SCR, and the color bar is displayed along the vertical axis on the left side of the graph frame.

  Time and pixel values are assigned to the horizontal and vertical axes of the graph frame, respectively. Specifically, a time from time T0 described above to time Tn is assigned to the horizontal axis. On the vertical axis, a value of up to 250% is assigned with the value of the target pixel forming the MRI image at the target slice position at time T0 as an initial value. In addition, the color bar displayed along the vertical axis indicates a different color depending on the pixel value.

  In step S19, the initial phase color mode and the delayed phase color mode are initialized. The initial phase color mode is a mode that defines which of the initial phase color maps MP01fst, MP01md, and MP01slw is displayed. A total of seven modes are prepared from a mode that displays all to a mode that displays only one. The Similarly, the delay phase color mode is a mode that defines which of the delay phase color maps MP1npst, MP1nplt, and MP1nwsh is displayed, and a total of 7 modes from a mode that displays all to a mode that displays only one. Is prepared.

  In the initial state, the initial phase color mode is set to a mode for displaying all of the initial phase color maps MP01fst, MP01md, and MP01slw, and the delayed phase color mode is set to a mode for displaying all of the delayed phase color maps MP1npst, MP1nplt, and MP1nwsh. Is done.

  In step S21, the display device 20 is requested to display complementary images IM01 and IM1n corresponding to the head slice position (= slice position P0). The display device 20 reads the target complementary images IM01 and IM1n from the DRAM 22, and displays the read complementary images IM01 and IM1n on the screen SCR.

  In step S23, an initial phase color map MP01 corresponding to the head slice position is created according to the initial phase color mode set in step S19. In step S25, the delayed phase color map MP1n corresponding to the head slice position is created in accordance with the delayed phase color mode set in step S19.

  Since the initialized initial phase color mode and delayed phase color mode are as described above, in step S23, the initial phase color map MP01 is created by combining the initial phase color maps MP01fst, MP01md, and MP01slw, and the delayed phase color map is obtained. A delayed phase color map MP1n is created by combining MP1npst, MP1nplt, and MP1nwsh.

  In step S27, the display device 20 is requested to display the initial phase color maps MP01 and MP1n thus created. The display device 20 reads the initial phase color map MP01 and the delayed phase color map MP1n from the DRAM 22, and multiplexes the read initial phase color maps MP01 and MP1n on the complementary images IM01 and IM1n displayed on the screen SCR, respectively.

  The complementary images IM01 and IM1n at the first slice position form the images shown in FIGS. 3A and 3B, and the initial phase color maps MP01fst, MP01md, and MP01slw at the first slice position are shown in FIGS. C), when the delay phase color maps MP1npst, MP1nplt, and MP1nwsh at the head slice position form the maps shown in FIGS. 5D to 5F, the complementary images IM01 to IM1n, the initial phase color map MP01 and delayed phase color map MP1n are displayed on the screen SCR in the manner shown in FIG. That is, the complementary images IM01 and IM1n are displayed side by side at the lower position of the screen SCR, and the initial phase color map MP01 and the delayed phase color map MP1n are multiplexed on the complementary images IM01 and IM1n, respectively.

  The color of the initial phase color map MP01 is synchronized with the color of the color bar. As a result, by comparing the initial phase color map MP01 with the color bar, it is possible to easily grasp whether the initial phase characteristic of each pixel is “Fast”, “Medium”, or “Slow”.

  In step S29, a graphic image (hereinafter simply referred to as “color mode information”) representing the color mode information indicating the initial phase color mode and the delayed phase color mode initialized in step S19 is created on the DRAM 22, and the color is displayed. The display device 20 is requested to display mode information. The display device 20 reads the target color mode information from the DRAM 22, and displays the read color mode information side by side at the lowest position of the screen SCR.

  As shown in FIG. 7, the color mode information has three items “FAST”, “MEDIUM” and “SLOW” corresponding to the initial phase, and “PERSISTENT” and “PLATEAU” corresponding to the delay phase. And “WASHOUT”. Since the initialized initial phase color mode and delayed phase color mode are as described above, all of the three items corresponding to the initial phase and the three items corresponding to the delayed phase are displayed with high luminance.

  In step S31, it is repeatedly determined whether or not a slice position changing operation has been performed with the keyboard 16 and / or the mouse 18. When the determination result is updated from NO to YES, the display positions of the pointers PT01 and PT1n are initialized in step S33. By the initialization, the pointers PT01 and PT1n point to the initial positions on the tomography.

  In step S35, the value of the variable K is changed to a value according to the slice position changing operation. In step S37, the display device 20 is requested to display complementary images IM01 and IM1n corresponding to the slice position PK. The display device 20 reads the target complementary images IM01 and IM1n from the DRAM 22, and displays the read complementary images IM01 and IM1n on the screen SCR instead.

  In step S39, an initial phase color map MP01 corresponding to the slice position PK is created according to the current initial phase color mode. In step S41, the delay phase color map MP1n corresponding to the slice position PK is created according to the current delay phase color mode.

  In step S43, it is determined whether or not the current initial phase color mode is in the initial state. If the determination result is YES, the process proceeds directly to step S49. If the determination result is NO, the process proceeds to steps S45 and S47. Proceed to step S49. The processes in steps S45 and S47 will be described later.

  In step S49, the display device 20 is requested to display the initial phase color map MP01 and the delayed phase color map MP1n in multiple displays. The display device 20 reads the initial phase color map MP01 and the delayed phase color map MP1n from the DRAM 22, and reads the read initial phase color map MP01 and delayed phase color map MP1n on the complementary images IM01 and IM1n displayed on the screen SCR, respectively. Multiplex.

  The complementary images IM01 and IM1n at the slice position PK form the images shown in FIGS. 4A and 4B, and the initial phase color maps MP01fst, MP01md, and MP01slw at the slice position PK are shown in FIGS. C), and when the delay phase color maps MP1npst, MP1nplt, and MP1nwsh at the slice position PK form the maps shown in FIGS. 6D to 6F, the initial phase color mode and the delay phase color mode Is the initial state, the complementary images IM01 to IM1n, the initial phase color map MP01, and the delayed phase color map MP1n are alternatively displayed on the screen SCR in the manner shown in FIG.

  In step S51, a character image representing each of the pointers PT01 and PT1n (hereinafter simply referred to as “pointer PT01” or “pointer PT1n”) is developed in the DRAM 22, and the display device 20 is requested to display the pointers PT01 and PT1n. . The display device 20 reads the pointers PT01 and PT1n from the DRAM 22, and displays the read pointers PT01 and PT1n on the initial phase color map MP01 and the delay phase color map MP1n on the screen SCR.

  The pointers PT01 and PT1n point to a common position on the slice, and the pointing position follows the processing of step S33 or step S61 described later. Therefore, when common coordinates are assigned to the initial phase color map MP01 and the delay phase color map MP1n, the coordinate value indicating the multiplexed position of the pointer PT01 matches the coordinate value indicating the multiplexed position of the pointer PT1n. The pointers PT01 and PT1n point to pixels that represent a common position on the slice.

  In step S53, it is determined whether or not the pixel pointed by the pointer PT1n is colored. If the determination result is YES, the process proceeds to step S55.

  In step S55, the MRI image representing the slice at the slice position PK at each of the times T0 to Tn is transferred from the main memory 24 to the DRAM 22, and the pixel to which the pointer PT01 or PT1n points from each of the transferred five frames of the MRI image. Extract the value of. In step S55, the graph G01 is created based on the two pixel values corresponding to the times T0 and T1, respectively, and the graph G1n is created based on the four pixel values corresponding to the times T1 to Tn.

  The graph G01 represents a temporal change in the initial phase of the pixel value pointed by the pointer PT01. The graph G1n represents a temporal change in the delay phase of the pixel value directed by the pointer PT1n. The created graphs G01 and G1n are drawn on the DRAM 22.

  In step S55, the display device 20 is requested to display graphs G01 and G1n drawn in the DRAM 22. The display device 20 reads the graphs G01 and G1n from the DRAM 22, and displays the read graphs G01 and G1n on the screen SCR according to the frame displayed in step S15. The graphs G01 and G1n are displayed, for example, as shown in FIG.

  The graphs G01 and G1n will be described in more detail with reference to FIGS. Here, for convenience of explanation, a graph whose initial phase characteristic is “Fast” is defined as “G01fst”, a graph whose initial phase characteristic is “Medium” is defined as “G01md”, and a graph whose initial phase characteristic is “Slow”. Is defined as “G01slw”. Also, a graph having a delay phase characteristic “Persistent” is defined as “G1npst”, a graph having a delay phase characteristic “Plateau” is defined as “G1nplt”, and a graph having a delay phase characteristic “Washout” is defined as “G1nwsh”. Define.

  In the initial phase, the graph G01fst, G01md, or G01slw is drawn as shown in FIG. In each of the graphs G01fst, G01md, and G01slw, the value of the target pixel at time T0 is set as an initial value, and an increase rate from the initial value is shown.

  When the graph G01fst is drawn in the initial phase, the graph G1npst, G1nplt, or G1nwsh is drawn continuously on the graph G01fst as shown in FIG. When the graph G01md is drawn in the initial phase, the graph G1npst, G1nplt or G1nwsh is drawn continuously on the graph G01md as shown in FIG. When the graph G01slw is drawn in the initial phase, the graph G1npst, G1nplt or G1nwsh is continuously drawn on the graph G01slw as shown in FIG. 10 to 12, the graphs G1npst, G1nplt, and G1nwsh indicate the rate of increase / decrease of the pixel value from the initial value.

  In step S55, the graphs G01 and G1n are drawn in this way. When the process of step S55 is completed, the process proceeds to step S59. If the determination result in step S53 is NO, the graphs G01 and G1n are not displayed in step S57, and then the process proceeds to step S59.

  In step S59, it is determined whether or not a pointer moving operation has been performed with the mouse 18, and in step S63, it is determined whether or not a slice position changing operation has been performed with the keyboard 16 and / or the mouse 18. If the decision result in the step S59 is YES, the positions of the pointers PT01 and PT1n are commonly changed in a step S61, and thereafter, the process returns to the step S51. Moreover, if the determination result of step S63 is YES, it will return to step S35.

  Accordingly, the display modes of the pointers PT01 to PT1n and the graphs G01 to G1n dynamically change according to the pointer movement operation, and the display modes of the complementary images IM01 to IM1n, the initial phase color map MP01, and the delay phase color map MP1n are slice position change operations. It changes dynamically according to.

  If both the determination result in step S59 and the determination result in step S63 are NO, it is determined in step S65 whether or not the initial phase color mode changing operation has been performed by the keyboard 16 and / or the mouse 18, and the keyboard 16 and In step S71, it is determined whether or not the delayed phase color mode changing operation has been performed by the mouse 18.

  The initial phase color mode change operation accepted in step S65 corresponds to an operation of selecting the initial phase characteristics whose visualization should be restricted from “Fast”, “Medium”, and “Slow”. If the decision result in the step S65 is YES, the initial phase color mode is changed in a step S67, the color mode information is changed in a step S69, and then the process returns to the step S39.

  In step S39, the initial phase color map MP01 corresponding to the slice position PK is created according to the changed initial phase color mode. In the subsequent step S41, the delayed phase color map MP1n corresponding to the slice position PK is created according to the changed delayed phase color mode.

  If the changed initial phase color mode is different from the initial phase color mode in the initial state, the determination result in step S43 is determined to be NO, and the process proceeds to step S45. In step S45, the region R1 where the color appears in the initial phase color map MP01 created in step S39 is specified, and the region R2 common to the region R1 is specified on the delayed phase color map MP1n created in step S41. . In step S45, the delayed phase color map MP1n created in step S41 is modified so that the color outside the region R2 specified in step S43 is excluded.

  When “Slow” is selected as the initial phase characteristic whose visualization should be restricted as a result of the initial phase color mode changing operation, the initial phase color map MP01, the delayed phase color map MP1n, and the color mode information are as shown in FIG. Updated. The processing at this time will be described in detail with reference to FIGS. 15 (A) and 15 (B).

  First, the initial phase color map MP01slw disappears from the initial phase color map MP01. Subsequently, a region R1 where a color appears in the initial phase color map MP01 is specified (see FIG. 15A), and a region R2 on the delayed phase color map MP1n common to the region R1 is specified (FIG. 15 ( B)). Colors outside the region R2 are excluded from the delayed phase color map MP1n. In addition, the item “SLOW” forming the color mode information is displayed with low luminance.

  The delayed phase color mode change operation accepted in step S71 in FIG. 23 corresponds to an operation of selecting a delayed phase characteristic whose visualization should be restricted from “Persistent”, “Plateau”, and “Washout”. If the decision result in the step S71 is YES, the delayed phase color mode is changed in a step S73. In step S75, the delayed phase color map MP1n on the DRAM 22 is modified according to the changed delayed phase color mode. When the correction is completed, the color mode information is changed in step S75, and then the process returns to step S49.

  When the delayed phase color mode changing operation is performed in the display state shown in FIG. 13 and “Persistent” is selected as the delayed phase characteristic whose visualization should be limited, the initial phase color map MP01, the delayed phase color map MP1n, and the color mode information are displayed. Is displayed as shown in FIG. According to FIG. 14, the delayed phase color map MP1npst disappears from the delayed phase color map MP1n, and the item “PERSISTENT” forming the color mode information is displayed with low luminance. As can be seen from FIG. 16 in which the delayed phase color map MP1n and the delayed phase color mode information are enlarged, when the delayed phase color mode change operation is performed, some of the colors that appear inside the region R2 are changed. Excluded according to the delayed phase color mode.

  When an initial phase color mode changing operation is further performed from this point, and “Medium” is additionally selected as an initial phase characteristic whose visualization should be limited, the initial phase color map MP01, the delayed phase color map MP1n, and the color mode information are Are displayed in the manner shown in FIG. According to FIG. 17, the initial phase color map MP01md disappears from the initial phase color map MP01, and the color of the region common to the initial phase color map MP01md disappears from the delayed phase color map MP1n. In addition, the “MEDIUM” item that forms the color mode information is displayed with low brightness.

  In this state, when the delayed phase color mode changing operation is further performed and “Plateau” is selected as the delayed phase characteristic whose visualization should be restricted, the initial phase color map MP01, the delayed phase color map MP1n, and the color mode information are shown in FIG. 18 is displayed in the manner shown in FIG. According to FIG. 18, the delayed phase color map MP1nplt disappears from the delayed phase color map MP1n, and the item “PLATEAU” forming the color mode information is displayed with low luminance.

  According to BI-RADS-MRI, the part having the initial phase characteristic “Fast” and the delayed phase characteristic “Washout” is considered to have the highest malignancy, and the display state shown in FIG. 18 is selected. Visualization with the highest malignancy limited to each other is possible.

  As can be seen from the above description, the CPU 14 creates initial phase color maps MP01fst, MP01md, and MP01slw corresponding to the initial phase characteristics of “Fast”, “Medium”, and “Slow” based on the initial phase MRI image. (S7) Delay phase color maps MP1npst, MP1nplt, MP1nwsh respectively corresponding to the delay phase characteristics of “Persistent”, “Plateau”, and “Washout” are created based on the MRI image of the delay phase (S9).

  When accepting an initial phase color mode change operation for selecting an initial phase characteristic whose visualization should be restricted from among the three initial phase characteristics, the CPU 14 receives the initial phase color map from which the color corresponding to the selected initial phase characteristic is excluded. MP01 is displayed based on the initial phase color map MP01fst, MP01md, MP01slw (S67, S39, S49), and the color outside the region R2 common to the region R1 where the color appears on the initial phase color map MP01 is excluded. The delayed phase color map MP1n is displayed based on the delayed phase color maps MP1npst, MP1nplt, MP1nwsh (S41 to S49).

  Therefore, when the initial phase characteristic for which visualization is to be restricted is changed by the initial phase color mode change operation, the expression mode of the initial phase color map MP01 changes, and further the expression mode of the delayed phase color map MP1n changes. This improves convenience when diagnosing the affected area.

10 ... Diagnosis support device 14 ... CPU
DESCRIPTION OF SYMBOLS 20 ... Display apparatus 24 ... Main memory 30 ... MRI apparatus 40 ... Communication network

Claims (10)

A first color map in which each pixel represents a color corresponding to any one of a plurality of first time phase characteristics is generated based on a first tomographic image corresponding to the first time phase and representing a tomogram of an affected area. Color map creation means,
A second color map in which each pixel represents a color corresponding to any one of a plurality of second time phase characteristics is generated based on a second tomographic image corresponding to the second time phase and representing a tomogram of the affected area. 2 color map creation means,
First receiving means for repeatedly receiving a first selection operation for selecting a first time phase characteristic whose visualization should be restricted from the plurality of first time phase characteristics;
A first correction color map from which a color corresponding to the first time phase characteristic selected by the first selection operation is excluded is displayed based on the first color map created by the first color map creating means. A corrected color map display means, and a second correction in which a color outside the second area common to the first area where the color appears on the first corrected color map displayed by the first corrected color map display means is excluded A diagnosis support apparatus comprising second modified color map display means for displaying a color map based on the second color map created by the second color map creating means. The first correction color map display means and the second correction color map display means execute processing in parallel with each other;
The diagnosis support apparatus according to claim 1, wherein the first receiving unit receives the first selection operation in parallel with the processing of the first corrected color map display unit and the second corrected color map display unit. Second receiving means for receiving a second selection operation for selecting a second time phase characteristic whose visualization should be restricted from the plurality of second time phase characteristics; and a second time phase characteristic selected by the second selection operation The diagnosis support apparatus according to claim 1, further comprising: a color exclusion unit that excludes a color corresponding to the second correction colormap to be displayed by the second correction colormap display unit.   The graph display means which displays the graph showing the temporal change of the pixel value in the desired position on the tomographic image based on the first tomographic image and the second tomographic image. The diagnosis support apparatus described.   A first correction color map in which a first pointer and a second pointer that commonly point the desired position in accordance with a pointer movement operation are respectively displayed by the first correction color map display means and the second correction color map display means; 5. The diagnosis support apparatus according to claim 4, further comprising pointer multiplexing means for multiplexing each of the second corrected color maps.   The diagnosis support apparatus according to claim 4, further comprising a graph display restriction unit that restricts processing of the graph display unit when the desired position corresponds to a position outside the second region. The horizontal and vertical axes of the graph are assigned time and the pixel value, respectively.
The diagnosis according to any one of claims 4 to 6, further comprising color bar display means for displaying color bars indicating a plurality of colors respectively corresponding to the plurality of first time phase characteristics along a vertical axis of the graph. Image processing device. First representative image display means for displaying a first representative image representative of the first time phase based on the first tomographic image, and a second representative image representative of the second time phase as the second tomographic image. Further comprising a second representative image display means for displaying on the basis of,
The first correction color map display means multiplexes the first correction color map on the first representative image displayed by the first representative image display means;
8. The diagnosis support apparatus according to claim 1, wherein the second corrected color map display means multiplexes the second corrected color map on the second representative image displayed by the second representative image display means. A diagnostic support method executed by a processor of a diagnostic support device,
A first color map in which each pixel represents a color corresponding to any one of a plurality of first time phase characteristics is generated based on a first tomographic image corresponding to the first time phase and representing a tomogram of an affected area. Color map creation step,
A second color map in which each pixel represents a color corresponding to any one of a plurality of second time phase characteristics is generated based on a second tomographic image corresponding to the second time phase and representing a tomogram of the affected area. 2 color map creation step,
A first receiving step of repeatedly receiving a first selection operation for selecting a first time phase characteristic whose visualization should be restricted from the plurality of first time phase characteristics;
A first correction color map from which a color corresponding to the first time phase characteristic selected by the first selection operation is excluded is displayed based on the first color map created by the first color map creation step. A correction color map display step, and a second correction in which a color outside the second region common to the first region where the color appears on the first correction color map displayed by the first correction color map display step is excluded A diagnostic support method comprising a second modified color map display step of displaying a color map based on the second color map created by the second color map creation step. In the processor of the diagnostic support device,
A first color map in which each pixel represents a color corresponding to any one of a plurality of first time phase characteristics is generated based on a first tomographic image corresponding to the first time phase and representing a tomogram of an affected area. Color map creation step,
A second color map in which each pixel represents a color corresponding to any one of a plurality of second time phase characteristics is generated based on a second tomographic image corresponding to the second time phase and representing a tomogram of the affected area. 2 color map creation step,
A first receiving step of repeatedly receiving a first selection operation for selecting a first time phase characteristic whose visualization should be restricted from the plurality of first time phase characteristics;
A first correction color map from which a color corresponding to the first time phase characteristic selected by the first selection operation is excluded is displayed based on the first color map created by the first color map creation step. A correction color map display step, and a second correction in which a color outside the second region common to the first region where the color appears on the first correction color map displayed by the first correction color map display step is excluded A diagnostic support program for executing a second modified color map display step for displaying a color map based on the second color map created by the second color map creation step.

Images