JP6162575B2 - Ultrasound diagnostic imaging equipment - Google Patents

Description

  Embodiments described herein relate generally to an ultrasonic diagnostic imaging apparatus that images shear elastic waves.

  Since the ultrasonic diagnostic imaging apparatus is a non-invasive diagnostic apparatus without exposure, it is used in a wide range of clinical fields from diagnosis to follow-up. In recent years, elastography has been developed as a new diagnostic imaging method for detecting the elasticity (hardness) of tissue and evaluating it non-invasively and objectively as well as improving its performance. As a result, cancer evaluation of fibroadenoma such as breast and liver is expected.

  There are various methods for elastography. Among them, there is a parametric imaging method using shear elastic waves. The velocity of the shear elastic wave propagating in the substance correlates with the elastic coefficient of the substance, and it can be said that the faster the propagation speed, the harder the substance. Specifically, tissue hardness is evaluated by measuring the propagation velocity of shear elastic waves (transverse elastic waves) generated by irradiating convergent ultrasonic waves (hereinafter referred to as push pulses) (see, for example, Patent Document 1). ).

  However, when generating the shear elastic wave, the acoustic power of the push pulse to be transmitted is larger than the conventional power, and there is concern about the influence on the human body. In particular, it is necessary to avoid the transmission of push pulses to sites that are worried about acoustic effects, such as fetuses that are unsuitable for safety, bones with large ultrasonic reflections, and sites where contrast agents are used where tissue damage is a concern. However, when this neighborhood is inspected, there is a possibility that a push pulse is erroneously transmitted.

Special table 2012-531937 gazette

  The problem to be solved by the present invention is to solve the above-mentioned problem and to provide an ultrasonic diagnostic imaging apparatus capable of limiting, avoiding, and notifying a warning of push pulse transmission to a part where the acoustic influence is a concern. And

In order to achieve the above object, an ultrasonic diagnostic imaging apparatus according to the present embodiment includes an ultrasonic probe that transmits and receives an ultrasonic wave to a subject, and a transmission unit that transmits a drive signal that generates a push pulse to the ultrasonic probe. A receiving unit that receives a detection signal obtained by detecting the shear wave generated by the push pulse by the probe; a region of interest setting unit that sets a region of interest to be irradiated with the push pulse on an ultrasound image; and the push pulse A prohibited region setting unit for setting a prohibited region for avoiding irradiation of the light, a transmission region determining unit for determining whether or not the region of interest is included in the prohibited region, and transmission control data for the push pulse. A transmission control data storage unit, a transmission history unit that collects transmission histories of push pulses for the same region of interest from the transmission control data, and the transmission history A constraint condition setting unit for setting a constraint condition for transmission limit of the push pulse based on a transmission control unit which on the basis of the determination result and the constraints of the transmission region determination unit performs transmission control with respect to the irradiation of the push pulse , have a, the transmission control data is associated with uniquely identifying a patient identifier patient, the transmission control unit, to the diagnosis of the same patient and the same region of interest, the transmission region of interest stored in the past Obtain push from control data and send push pulse.

1 is a block configuration diagram of an ultrasonic diagnostic imaging apparatus according to a first embodiment. Explanatory drawing which sets the region of interest of a shear wave diagnostic mode within the transmission range of an ultrasonic wave. The flowchart figure of the shear wave diagnostic mode which concerns on this embodiment. Explanatory drawing of the region of interest setting and prohibition region setting with respect to the ultrasonic image on B mode. The example of alerting (warning) at the time of area | region control which concerns on this embodiment. The example of other alerting (warning) at the time of area | region control which concerns on this embodiment. The database example of the transmission control data concerning this embodiment. An example of alerting (warning) during history control according to the present embodiment. The example of other alerting (warning) at the time of the history control which concerns on this embodiment. The block block diagram of the ultrasonic image diagnostic apparatus in 2nd Embodiment. The flowchart figure of the shear wave diagnostic mode which concerns on this embodiment. Explanatory drawing of position alignment with the other modality image which concerns on this embodiment. The side-by-side display example which concerns on this embodiment. The flowchart figure for calling the past region of interest which concerns on this embodiment. The database example of the transmission control data which concerns on this embodiment. The block block diagram of the ultrasonic image diagnostic apparatus in 3rd Embodiment. The flowchart figure of the shear wave diagnostic mode when an ultrasonic probe is left in the air.

  Hereinafter, embodiments will be described in detail with reference to FIGS. 1 to 17. In the following description, components having substantially the same function and configuration are denoted by the same reference numerals, and redundant description will be given only when necessary.

(First embodiment)
The ultrasonic diagnostic imaging apparatus of the present embodiment shown in FIG. 1 has an ultrasonic probe 11 that transmits and receives ultrasonic waves with a transducer attached to the tip, transmits a drive signal for generating ultrasonic waves, and reflects from the subject. Transmission / reception unit 12 that detects an echo signal as an electrical signal, processor unit 13 that performs signal processing for various diagnostic modes of ultrasonic image diagnosis, and a scan converter that converts processing signals of various diagnostic modes performed by the processor unit 13 into video signals 14. Along with the diagnostic image output from the scan converter, the display monitor 15 displays various regions of interest, warning messages for alerting, various operation information such as side-by-side display of multiple medical images, and image information. Various control commands for the image generation unit 16 and the ultrasonic diagnostic imaging apparatus for display are input. Sakushoku 17, and an interface unit 18, a control unit 19 for integrally controlling the ultrasound system to mediate a variety of signals for controlling the ultrasound system. On the console 17, user interface devices such as a mouse, a trackball, a joystick, a keyboard, and various switches are arranged for inputting various control commands.

  The ultrasonic diagnostic imaging apparatus of this embodiment includes a parametric imaging mode (hereinafter referred to as a shear wave diagnostic mode) using shear elastic waves. The ultrasonic probe 11 can transmit a push pulse which is a convergent ultrasonic wave, and can capture a shear elastic wave generated by irradiation of the push pulse. The processor unit 13 includes a shear wave processor 131 that performs shear elastic wave signal processing, and displays the shear elastic wave velocity in association with the tissue hardness by a display method such as colorization. The processor unit 13 includes a plurality of Doppler spectrum processors 132 that observe movement such as blood flow from the Doppler amount, a color Doppler processor 133 that displays the Doppler amount in color, and a B-mode image processor 134 that processes a B-mode image. A processor for the diagnostic imaging mode.

  Furthermore, the ultrasonic diagnostic imaging apparatus of this embodiment has a push pulse transmission control function. When a push pulse is transmitted to a part that is concerned about the acoustic influence, it is possible to perform processing such as a warning for alerting the operator, further limiting or avoiding the push pulse transmission. The control unit 19 controls the ultrasonic diagnostic imaging apparatus in an integrated manner. The configuration of the part that is a feature of the present embodiment will be mainly described.

  The control unit 19 of the present embodiment includes a transmission control unit 190 that performs transmission control of push pulses. Transmission control performed by the transmission control unit 190 is broadly divided into area control for controlling the transmission area of push pulses and history control for controlling according to the history of push pulses transmitted in the vicinity of the same part.

  First, region control will be described. Area control is an area unsuitable for push pulse transmission, such as fetuses that are unsuitable for push pulse irradiation, bones with high ultrasonic reflectivity, and parts that use contrast agents. Transmission control).

  Therefore, in this embodiment, the region of interest setting unit 191 that stores the region of interest in the “shear wave diagnostic mode” set on the ultrasound image (B mode image) and the acoustic effect on the B mode image are also concerned. A prohibited region setting unit 192 for setting a region (or part) to be transmitted and storing this as a prohibited region for avoiding transmission of push pulses, and a transmission region determining unit 193 for determining whether the region of interest is included in the prohibited region. have. And based on the determination result of the transmission area | region determination part 193, it has the message part 194 which emits the alerting (warning) message about transmission of a push pulse with respect to an operator. The transmission control unit 190 prohibits transmission of a push pulse when it is desired to perform transmission control for a push pulse in addition to a warning for alerting an operator.

  Next, history control will be described. Since the push pulse has a high acoustic output, there is a risk of damage to the part or heat generation when the same part is irradiated many times. Therefore, in this embodiment, a transmission control data storage unit 195 that stores transmission control data of push pulses performed in the past, a constraint condition setting unit 196 that defines transmission constraint conditions of push pulses, and a transmission control data storage unit 195 A transmission history unit 197 that inquires about the past transmission history and performs transmission control determination based on the transmission constraint condition. Further, a medical image storage unit 198 that holds a B-mode image when push pulse transmission is performed is provided as necessary. Then, not only the transmission control based on the transmission restriction condition but also the transmission restriction condition is displayed on the display monitor 15 as an alert to the operator.

  The operation of the ultrasonic diagnostic imaging apparatus configured as described above will be specifically described. FIG. 2 is an explanatory diagram for setting a region of interest in the “shear wave diagnostic mode” within the ultrasonic transmission range. There are a plurality of types of ultrasonic probes such as a convex type and a linear type. In this embodiment, the convex type will be described as an example. The ultrasonic probe 11 is applied perpendicularly to the body surface 20, and a transmission range of ultrasonic waves from the ultrasonic probe 11 is denoted by reference numeral 21. Regions of interest 22 a and 22 b for the “shear wave diagnostic mode” are set for the transmission range 21. The region of interest 22a, 22b is transmitted by transmitting push pulses 23a, 23b, which are convergent ultrasonic waves, to the regions of interest 22a, 22b, capturing shear elastic waves generated thereby, and performing signal processing by the shear wave processor 131. The structure hardness of can be evaluated. In the following description, an example of evaluating liver tissue hardening will be described.

  FIG. 3 is a flowchart in the “shear wave diagnostic mode”. FIG. 4 is an explanatory diagram of region-of-interest setting and prohibition region setting for an ultrasound image on a B-mode image.

  As shown in FIG. 4, in step ST <b> 301, first, the “B mode diagnosis mode” is selected to display the B mode image 41 of the liver of the subject on the display monitor 15. As described above, the B-mode image is signal-processed by the B-mode image processor 134.

  In order to evaluate the hardness of the liver tissue, the operator operates the console 17 to switch to the “shear wave diagnostic mode”. At this time, the display of the B-mode image 41 is not changed, but a menu of “region of interest setting” 42 “prohibited region setting” 43 is displayed on the screen of the display monitor 15.

  In step ST302, the operator selects a “prohibited area setting” 43 menu that avoids push pulse transmission. When the menu of “prohibited area setting” 43 is selected, a marker for setting the prohibited area 44 is displayed on the display monitor 15, and the prohibited area 44 can be freely formed on the B-mode image using the console 17. (It is displayed as a polygon in FIG. 4). Here, the portion corresponding to the spinal cord (bone) is marked. The set value of the prohibited area marked in this way is stored in the prohibited area setting unit 192.

  The marked forbidden area operates so as to be automatically set by image discrimination even when the ultrasonic probe 11 moves, but if it cannot follow a large movement, the prohibited area is marked again.

  In addition, in the “B mode diagnosis mode”, an ultrasonic echo amount or an image is analyzed, and an area that can be automatically determined, such as bone and amniotic fluid, is set as a prohibited area in real time. For a region using a contrast agent, image processing for extracting only the reflection of the region where the contrast agent is used is performed to calculate the use region of the contrast agent. This area is also automatically set as a prohibited area. The forbidden area is set wide in consideration of the range affected by the push pulse.

  In step ST <b> 303, the operator selects a menu of “region of interest setting” 42. When the menu of “region of interest setting” 42 is selected, a marker frame for setting the region of interest 45 is displayed on the display monitor 15, and the center position of the marker frame and the size of the region are displayed using the user interface of the console 17. You can freely set the size. The coordinate value of the marker frame set in this way is stored in the region-of-interest setting unit 191 as the setting value of the region of interest 45.

  In step ST304, the set value of the region of interest 45 is compared with the set value of the prohibited region 44 to determine whether the region of interest 45 is included in the prohibited region 44. This determination is performed by the transmission area determination unit 193, and the determination result is transmitted to the transmission control unit 190. If even a part of the region of interest 45 is included in the prohibited region 44 (ST304: No), the process proceeds to step ST305.

  In step ST305, the message unit 194. A warning message for alerting the operator is generated. 5 and 6 show examples of warning messages. In FIG. 5, a message “You are trying to set a region of interest in the prohibited area! Please set it outside the prohibited area.” Is displayed. Since the determination performed by the transmission region determination unit 193 is determined in real time with the movement of the region of interest 45, the operator resets the region of interest outside the prohibited region as indicated by the dotted arrow (returns to ST303). be able to. If the region of interest 45 is not to be changed, the process proceeds to step ST306, and the warning “A region of interest has been set in the prohibited region !!!! Push pulse cannot be transmitted” in FIG. 6 is displayed. Prohibit transmission of and end.

  If the region of interest 45 is not included in the prohibited region 44 in step ST304 (ST304: Yes), the process proceeds to step ST307.

  In step ST307, push pulse transmission conditions based on history control and constraint conditions are calculated. In order to perform history control, the transmission control unit 190 inquires of the transmission history unit 197 about the transmission history so far. The transmission history unit 197 searches the transmission history for substantially the same position (or the same part) for the currently diagnosed patient from the transmission control data stored in the transmission control data storage unit 195.

  FIG. 7 is an example of a database (transmission control data 71) stored in the transmission control data storage unit 195. In this database example, a patient ID that uniquely identifies a patient in one record, a diagnosed part, a region of interest coordinate set in a shear wave diagnosis mode, a push pulse transmission power, a push pulse transmission time, an irradiation time, etc. Field items are recorded. Further, the prohibited area coordinates and the link address where the diagnosed ultrasonic image is stored are recorded as optional field items.

  For example, when transmitting a push pulse to the patient A, the transmission history unit 197 extracts a database record for the patient A, and further extracts a record for the same part (liver). In the example of FIG. 1 and No. Two records are extracted.

  If a push pulse is repeatedly applied to the same part (region of interest), there is a risk of damage to the part or heat generation, so a retry prohibition time is set. Based on the transmission power of the past push pulse within this retry time, the transmission time of the push pulse, the irradiation time, the attenuation rate according to the distance from the transmission region, etc. ) Calculates values such as transmission power received in the past and integrated value of irradiation time. When those values exceed a predetermined threshold (hereinafter referred to as a constraint threshold) (ST308: YES), transmission control is performed according to a constraint set in advance in the constraint setting unit 196.

  The constraint conditions set in the constraint condition setting unit 196 are as follows, for example.

(Constraint 1) The user cannot set the region of interest.
(Restriction condition 2) Although a region of interest can be set, a push pulse cannot be transmitted until the next retry prohibition time has elapsed.
(Restriction condition 3) The transmission condition is automatically adjusted so that the transmission power of the push pulse is less than or equal to the restriction threshold value.

  If the transmission history unit 197 determines that push pulse transmission control is required (ST308: YES), a warning message for alerting the operator is displayed on the display monitor 15 in step ST309. 8 and 9 are examples of alert (warning) messages during history control. For example, as shown in FIG. 8, in the case of the restriction condition 1 or 2, a message such as “Set another region of interest or wait until the retry prohibition time elapses!” Is displayed. In addition, as shown in FIG. 9, in the case of restriction condition 3, the operator is permitted to determine whether or not transmission is possible, along with a warning such as “The transmission output of push pulse is reduced. Ask.

  In step ST310, transmission control (including transmission prohibition) is performed based on the constraint conditions.

  If the constraint threshold is not exceeded in step ST308 (ST308: No), transmission control is not performed, and a push pulse is transmitted with normal transmission power (step ST305).

  Here, optional field items set in the transmission control data 71 will be described. When the push pulse is transmitted and the ultrasonic image in the shear wave diagnosis mode is stored in the medical image storage unit 198, the link address of the ultrasonic image is recorded in the “link to ultrasonic image” field. In the “prohibited area coordinates” field, the spatial coordinates of the prohibited area set in the ultrasonic image are recorded at the same time.

  As a result, at the time of push pulse transmission, it is possible to determine whether or not they are the same part by reading an ultrasonic image transmitted in the past and comparing the regions of interest from image pattern matching.

  Further, in periodic diagnosis such as postoperative follow-up for the patient, the operator can read the patient's past data from the transmission control data 71 and automatically set the region of interest and the prohibited region. Is possible. That is, the past ultrasound image and the B-mode image being diagnosed are simultaneously displayed by a method such as side-by-side display, and the region of interest is set or prohibited by moving the ultrasound probe so that they substantially coincide with each other. The area is automatically set, and it is possible to evaluate the hardness of the liver tissue at the same position.

  As described above, according to the first embodiment, it is possible to safely diagnose the tissue hardness of a site where acoustic influence is a concern in the shear wave diagnosis mode. In other words, when sending a push pulse to a fetus that is unsuitable for safety, a part such as a bone with high ultrasonic reflectivity, or a part using a contrast agent, a warning is given to the operator. In addition, it is possible to control transmission of push pulses. In addition, since history control can be performed so that predetermined integrated power is not irradiated to the same part, it is possible to prevent risks such as damage to the part and heat generation.

(Second Embodiment)
In this embodiment, an ultrasonic probe is provided with a position sensor, and is linked with image data photographed with other modalities such as a CT apparatus (Computed Tomography) and an MRI apparatus (Magnetic Resonance Imaging) with high accuracy, and shearing is performed while referring to this. An embodiment for performing wave diagnosis will be described.

  FIG. 10 is a block diagram of the ultrasonic diagnostic imaging apparatus according to this embodiment. 1, a position sensor for acquiring the spatial position of the ultrasonic probe 11 and the direction (angle) of the irradiation surface is added to the ultrasonic probe 11, and the position sensor of this embodiment is a magnetic sensor 101. And a transmitter 102 for generating magnetism. Furthermore, the output information from the magnetic sensor 101 is processed to calculate the spatial position of the ultrasonic probe 11 and the direction of the irradiation surface, the position information acquisition unit 103, other modalities, PACS (Picture Archiving and Communication Systems), etc. Are connected to the network 104, and a coordinate interlocking unit 105 for interlocking a B-mode image with a medical image captured by another modality such as a CT apparatus or an MRI apparatus acquired via the network 104 is added.

  FIG. 11 is a flowchart of the “shear wave diagnostic mode” according to the present embodiment. FIG. 12 is an explanatory diagram of alignment with other modality images, and FIG. 13 is a side-by-side display example. Here, a description will be given by taking a captured image of a CT image as an example. Since most of the steps in FIG. 11 are the same as the flow in FIG. 3, the added steps and the steps that require additional explanation will be described.

  In step ST111, volume data captured by the CT apparatus is acquired as volume data of another modality. The volume data of the CT apparatus is obtained from an image server such as a CT apparatus or PACS via the network 104 and temporarily stored in the medical image storage unit 198. Then, a CT image is generated at a desired slice position.

  In step ST301, the currently diagnosed B-mode image is displayed. In step ST112, the coordinates of the CT image and the ultrasonic image are interlocked by the coordinate interlocking unit 105. As shown in FIG. 12, the method for linking the ultrasonic image and the volume data captured by the CT apparatus is completed in two steps. A circle indicates a target of a part to be aligned. First, while viewing the ultrasonic image and the CT image, the angle of moving the ultrasonic probe 11 is adjusted (step ST121). Then, after the angle adjustment is performed, the spatial coordinates are adjusted (step ST122). As a result, the B-mode image is associated with the coordinates based on the CT image. Then, as shown in FIG. 13, a CT image 13C is generated so that the B-mode image 13U being observed and the substantially same sectional view with respect to this B-mode image are interlocked, and both images are displayed on the side of the display monitor 15. Displayed by side.

  Volume data captured by a CT apparatus, an MRI apparatus or the like can originally determine the type of a part by image analysis. Therefore, the prohibited region setting unit 192 can acquire the coordinates of a region that is not suitable for the shear wave diagnosis mode, such as a bone, from the coordinates of the associated CT image. This is automatically set as a prohibited area. Furthermore, it is also possible to read an area marked at the time of diagnosis with the CT apparatus as a prohibited area. It is also possible to set a three-dimensional coordinate that combines information in the depth direction in consideration of the influence of the push pulse with respect to the region of interest.

  FIG. 14 is a flowchart for calling a past region of interest for the same patient. FIG. 15 is an example of transmission control data stored in the transmission control data storage unit 195.

  In the present embodiment, since the position sensor (magnetic sensor 101) is provided, it is possible to set the region of interest and the prohibited region with higher accuracy than in the first embodiment.

  In step ST141, the past record of the same part is searched from the transmission control data storage unit 195 using the patient ID. Further, as shown in FIG. 15, in the transmission control data 71b of this embodiment, a field item indicating a link to a CT image is added. As the region-of-interest coordinates of the transmission control data 71b, in addition to the region of interest set by the operator in the cross-sectional image, three-dimensional spatial coordinates taking into account the spatial influence of the push pulse in the depth direction are recorded. When a push pulse is transmitted to the same location as the past diagnosis, a past ultrasonic image or CT image is called from the transmission control database in step ST142, and the same position as the region of interest of the called image is obtained. Thus, the position of the ultrasonic probe 11 is adjusted. At this time, the moving direction of the ultrasonic probe may be displayed on the display monitor 15 so as to be at the same position.

  In step ST143, the transmission condition is read from the transmission control data 71b. Then, a push pulse is transmitted under the same conditions as the past push pulse conditions (step ST144).

  This makes it possible to easily perform shear wave diagnosis under the same conditions on the same site as a past diagnostic image.

  As described above, according to the second embodiment, the following effects can be achieved in addition to the first embodiment. In the present embodiment, by having the position sensor, it is possible to use the three-dimensional coordinates of other modalities as a reference. It is also possible to handle three-dimensional coordinates that take into account the depth direction information of the cross-sectional image for the region of interest. Even when the prohibited area is marked, the entire area to be diagnosed can be scanned in advance and marked three-dimensionally. It is also possible to set the prohibited area three-dimensionally by pre-scanning the contrast agent usage area in advance. Furthermore, an area marked with another modality can be read as a prohibited area.

  Accordingly, even in the area control / history control of push pulse transmission, it is possible to determine the overlap of the three-dimensional regions of interest and perform the transmission control. Therefore, highly accurate area control and transmission control are possible.

(Third embodiment)
In this embodiment, an embodiment in which shear wave diagnosis can be safely performed even when the operator separates the ultrasonic probe from the patient's body surface in the shear wave diagnosis mode will be described.

  FIG. 16 is a block configuration diagram of an ultrasonic diagnostic imaging apparatus according to the third embodiment. In addition to the second embodiment, an airborne detection unit 161 that detects that the ultrasonic probe has moved away from the body surface is added.

  Since this embodiment is provided with a position sensor, it is possible to detect that the device is left in the air by detecting that it is away from the probe position currently being diagnosed by a certain distance in the vertical direction with respect to the body surface. Further, when the position sensor is not provided as in the first embodiment, the fact that the pixel value (luminance value) of the B-mode image becomes brighter as a whole when the ultrasonic probe 11 is separated from the body surface, An aerial detection may be detected. Further, such various aerial detections may be combined.

  FIG. 17 is a flowchart of the shear wave diagnosis mode when the ultrasonic probe is left in the air. In step ST171, the “shear wave examination mode” is selected by the operator. The abandonment detection unit 161 always detects whether the ultrasonic probe 11 is away from the patient body surface during diagnosis. When it is detected that the device is left in the air (ST172: Yes), processing for exiting the “shear wave diagnostic mode” is performed (step ST173). When it is not detected that the device is left in the air (ST172: No), the diagnosis is continued and a push pulse is transmitted (step ST174). And when ending diagnosis (ST175: Yes), it progresses to the step which ends diagnosis. If the diagnosis is not terminated (ST175: No), the diagnosis is continued and the process returns to step 172.

  As described above, according to the third embodiment, when the ultrasonic probe is separated from the patient body surface, the transmission of the push pulse can be stopped, so that a safe diagnosis can be performed.

  Although several embodiments of the present invention have been described, these embodiments are presented by way of example and are not intended to limit the scope of the invention.

  In the embodiment, the hardness diagnosis of liver tissue has been described as a main example. However, the applied diagnosis is not limited to this. Further, the diagnosis procedure is not limited to the flowchart described above.

  These novel embodiments can be implemented in various other forms, and various omissions, replacements, and changes can be made without departing from the scope of the invention. These embodiments and modifications thereof are included in the scope and gist of the invention, and are included in the invention described in the claims and the equivalents thereof.

11 ... ultrasonic probe,
12: Transmitter / receiver,
13: Processor part,
14 ... Scan converter,
15 ... Display monitor,
16 ... image generation unit,
17 ... console,
18 ... interface part,
19: Control unit.

Claims (11)

An ultrasonic probe for transmitting and receiving ultrasonic waves to a subject; and
A transmitter for transmitting a drive signal for generating a push pulse to the ultrasonic probe;
A receiving unit that receives a detection signal obtained by detecting the shear wave generated by the push pulse by the probe;
A region-of-interest setting unit for setting a region of interest to be irradiated with the push pulse on an ultrasound image;
A prohibited area setting unit for setting a prohibited area for avoiding irradiation of the push pulse;
A transmission region determination unit that determines whether the region of interest is included in the prohibited region;
A transmission control data storage unit that stores transmission control data of the push pulse;
A transmission history unit that collects transmission history of push pulses for the same region of interest from the transmission control data;
A constraint condition setting unit for setting a constraint condition for limiting transmission of the push pulse based on the transmission history;
A transmission control unit that performs transmission control on the irradiation of the push pulse based on the determination result of the transmission region determination unit and the constraint condition ;
I have a,
The transmission control data is associated with a patient identifier that uniquely identifies a patient, and the transmission control unit acquires a region of interest saved in the past from the transmission control data for diagnosis of the same patient and the same region of interest. An ultrasonic diagnostic imaging device that transmits push pulses .   The ultrasound diagnostic imaging apparatus according to claim 1, further comprising a message unit that generates a warning message for the irradiation of the push pulse based on a determination result of the transmission region determination unit. The ultrasonic image diagnosis apparatus according to claim 2 , wherein the message unit further generates a warning message corresponding to the constraint condition. The constraint condition setting unit, retry transmission prohibition time ultrasound system of claim 1, wherein for setting the constraint condition based on the accumulated value of the transmission power irradiation time for the same region of interest within. An ultrasonic probe for transmitting and receiving ultrasonic waves to a subject; and
A transmitter for transmitting a drive signal for generating a push pulse to the ultrasonic probe;
A receiving unit that receives a detection signal obtained by detecting the shear wave generated by the push pulse by the probe;
A region-of-interest setting unit for setting a region of interest to be irradiated with the push pulse on an ultrasound image;
A prohibited area setting unit for setting a prohibited area for avoiding irradiation of the push pulse;
A transmission region determination unit that determines whether the region of interest is included in the prohibited region;
I have a,
The prohibited area setting unit determines a contrast agent use area from an ultrasound image,
An ultrasonic diagnostic imaging apparatus that automatically sets a prohibited area based on the contrast agent use area . The ultrasonic image diagnostic apparatus according to claim 5 , further comprising a message unit that generates a warning message for irradiation of the push pulse based on a determination result of the transmission region determination unit. The prohibition region setting unit, an ultrasonic image diagnostic apparatus according to claim 1 or claim 5, wherein setting a region which is marked manually on the ultrasound image as forbidden area. The prohibition region setting unit, an ultrasonic echo amount or ultrasound imaging apparatus automatically claim 1 or claim 5, wherein setting a prohibited area by image analysis of ultrasound images. A position sensor attached to the ultrasonic probe;
A position information acquisition unit for acquiring a spatial position of the ultrasonic probe from the position sensor;
Corresponding coordinates of an ultrasonic image with respect to the spatial position and a medical image taken with another modality, an ultrasonic image corresponding to the movement of the ultrasonic probe and a medical image taken with another modality Coordinate setting section to be linked,
The ultrasonic diagnostic imaging apparatus according to claim 1 or 5, further comprising: The ultrasonic diagnostic imaging apparatus according to claim 9 , wherein in the medical image taken with the other modality, the prohibited area is automatically set based on coordinates corresponding to a manually marked or automatically identified area. It further has an aerial leaving detection unit that detects that the ultrasonic probe has moved away from the body surface of the subject, and stops transmitting push pulses when the ultrasonic probe has moved away from the body surface of the subject. The ultrasonic diagnostic imaging apparatus according to claim 1 or 5 .

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