JP6173899B2 - Ultrasound diagnostic imaging equipment - Google Patents

Description

  Embodiments described herein relate generally to an ultrasonic diagnostic imaging apparatus that measures the movement of a fetal region.

  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, it has become possible to make detailed diagnosis of fetal development as well as improving its performance.

  It is known that physical and brain development can be evaluated by observing the movement of the fetal region. In particular, eye movements that can easily be correlated with central nervous function can be an important indicator for determining whether the fetal brain is developing normally as pregnancy progresses. However, in a specific examination, an inspector currently records a B-mode image of the ultrasonic diagnostic apparatus for a long time, and counts the number of exercises while viewing the moving image.

  However, measurement of the number of exercises requires a long time measurement of 1 hour or more. In the meantime, the examiner needs to maintain the position of the ultrasonic probe so as not to move, but the fetus itself may move greatly. Furthermore, since the moving image data to be recorded has a large capacity, there is a problem that the burden on the inspector is very heavy, for example, it takes time for analysis after the inspection.

  On the other hand, there is Doppler information obtained from the frequency transition of an ultrasonic echo as a method for detecting the movement of an object of interest such as blood flow (see, for example, Patent Document 1). However, there is a system that detects multiple movement states such as rapid eye movements and slow eye movements that appear according to the degree of fetal brain development, and further evaluates the degree of fetal brain development from the relationship with the pregnancy week do not do.

JP 2010-274120 A

  The problem to be solved by the present invention is to solve the above problems and to provide an ultrasonic diagnostic imaging apparatus for evaluating the degree of fetal brain development.

  In order to achieve the above object, the ultrasonic diagnostic imaging apparatus according to the present embodiment includes a sampling position setting unit that sets a sampling point in a fetal region on an ultrasonic image, and a movement of the region set by the sampling point. The obtained Doppler waveform information is acquired, and the motion detection unit that extracts the waveform determination parameter for each pulse of the Doppler waveform information is compared with the determination criterion for determining the motion state and the waveform determination parameter at the sampling point. A totaling unit that determines the exercise state of the set part and totalizes the determination result as statistical information together with the waveform determination parameter, a determination information storage unit that stores the determination criterion, and a total information storage that stores the statistical information Part.

1 is a block configuration diagram of an ultrasound diagnostic imaging apparatus in the present embodiment. Explanatory drawing at the time of setting a sampling point on the eyeball cross-sectional image of an ultrasonic image. Explanatory drawing at the time of setting a sampling point in an eyeball part or a lip part with respect to the face part of the fetus on an ultrasonic image. An example of Doppler waveform information at a sampling point. An example of a determination information database stored in a determination information storage unit. The flowchart figure in order to count the frequency | count of an exercise | movement of the site | part of a fetus. The detailed flowchart figure of a count process and an error process. First example of a warning message. Second example of warning message. Third example of warning message. The example of the total information database preserve | saved at a total information storage part. The 1st display example of a total result. The 2nd example of a display of a count result. The 3rd display example of a total result.

  Hereinafter, embodiments will be described in detail with reference to FIGS. 1 to 14. 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 according to the present embodiment shown in FIG. 1 transmits an ultrasonic probe 1 for transmitting and receiving ultrasonic waves with a transducer attached to the tip, transmits a drive signal for generating ultrasonic waves, and reflects it from a subject. The transmission / reception unit 2 that detects the echo signal as an electrical signal, the signal management processing unit 3 that performs signal processing for various diagnostic modes of ultrasonic image diagnosis, and the processing signals of various diagnostic modes performed by the signal management processing unit 3 are video signals. Additional information such as scan converter 4 to convert to, display of sampling points, warning message for alerting, side-by-side display of multiple medical images, and additional information such as image information 5, an image generation unit 7 for displaying the additional information on the monitor 6 together with the diagnostic image output from the scan converter 4, ultrasound A console 8 for inputting various control commands for the image diagnostic apparatus, an input control processing unit 9 for mediating various signals for controlling the ultrasonic image diagnostic apparatus, and a control unit 10 for controlling the ultrasonic image diagnostic apparatus in an integrated manner. Have.

  The signal management processing unit 3 includes a plurality of Doppler spectrum processors 11 that observe movement such as blood flow from the Doppler amount, a color Doppler processor 12 that displays the Doppler amount in color, and a B-mode image processor 13 that processes a B-mode image. A processor for the diagnostic imaging mode.

  On the console 8, user interface devices such as a mouse, a trackball, a joystick, a keyboard, and various switches are arranged for inputting various control commands.

  The control unit 10 controls the ultrasonic diagnostic imaging apparatus in an integrated manner, but only the configuration of the signal analysis processing unit 14 that characterizes the present embodiment is illustrated, and the operation of the signal analysis processing unit 14 will be mainly described.

  The signal analysis processing unit 14 sets, for example, a sampling position setting unit 141 that sets a sampling point in a fetal part of an ultrasonic image such as a B-mode image, and Doppler waveform information obtained from the movement of the part set at the sampling point. A motion detection unit 142 to be acquired, a motion state of a part set at the sampling point for each pulse of the Doppler waveform information is determined using a determination criterion, and a totaling unit 143 that counts the results as statistical information; It has a position shift detector 144 that detects the position shift of the fetus.

  Moreover, it has the determination information storage part 15 which preserve | saves the said criteria, the total information storage part 16 which preserve | saves the said statistical information, and the echo data preservation | save part 17 which preserve | saves the echo data of various diagnostic modes.

  The operation of the ultrasonic diagnostic imaging apparatus configured as described above will be specifically described.

FIG. 2 is an explanatory diagram when setting sampling points on an eyeball cross-sectional image of an ultrasonic image when a linear probe is used. Reference numeral 21 denotes a cornea, reference numeral 22 denotes a crystalline lens, reference numeral 23 denotes a vitreous body, reference numeral 24 denotes a scale, reference numeral 25 denotes a sampling point, and reference numeral 26 denotes a reference point. In FIG. 2, it is assumed that ultrasonic waves are transmitted from above.

  The sampling point 25 is preferably set at the edge of the crystalline lens 22. Since the crystalline lens 22 appears white on the B-mode image, it is advantageous for identification when setting the sampling point 25, and the response sensitivity of Doppler waveform information is also high. Furthermore, by using luminance difference information at the time of part movement and using it together with Doppler waveform information, it is possible to determine the part movement state with high accuracy. In FIG. 2, the reference point 26 is set to the optic disc, and the positional relationship with the sampling point 25 can be defined. When the fetus moves in the mother's womb, the reference point 26 and the position of the optic disc are shifted and observed. The movement of the sampling point 25 can also be detected by using the signal of the color Doppler processor 12.

  The positional deviation detection unit 144 corrects the position of the sampling point 25 by measuring the positional deviation of the reference point 25 to cause the reference point 26 to follow the optic disc.

  FIG. 3 is an explanatory diagram when setting sampling points in the eyeball part or the lip part of the face of the fetus on the ultrasonic image. The ultrasound probe 1 uses a two-dimensional matrix array probe to observe a three-dimensional image of the fetus. Reference numeral 31 denotes an eyeball part, reference numeral 32 denotes a nose tip, and reference numeral 33 denotes a lip part. The crystalline lens 22 is observed as a pair of points (not shown) at both ends of the perspective, or as a circular echo 34 as shown. When observing the eye movement of the fetus, a sampling point 25E is set using a pair of points at both ends of the eye or a ring-like echo 34 as a mark. Further, when observing fetal lip movement, a sampling point 25M is set for the mouth corner or lip opening. In the case of FIG. 2, the reference point is set at the nose tip 32. The sampling point and reference point set in this way are stored in the sampling position setting unit 141.

  The motion detection unit 142 acquires Doppler waveform information indicating the motion of the site of the sampling point from the Doppler spectrum processor 11 of the signal management processing unit 3. Then, a parameter characterizing the motion state is extracted from the Doppler waveform information (hereinafter referred to as a waveform determination parameter). The waveform determination parameter is compared with a determination criterion for determining the motion state of the part.

  FIG. 4 is an example of Doppler waveform information at the sampling points acquired by the motion detection unit 142. The horizontal axis represents time, and the vertical axis represents speed. For example, the eye movement will be described. In the eye movement, since the movement of the crystalline lens 22 from the stationary state and the movement back to the stationary point is detected again, the Doppler waveform information 41 is a pulse having substantially positive and negative waveforms.

  FIG. 4 shows examples of waveform determination parameters defined for each pulse. The maximum speed on the positive side is VP, the speed on the negative side is VM, the time interval between each pulse is TI, and TW indicates the pulse duration (pulse width). Various statistical information can also be added as waveform determination parameters by performing statistical processing such as averaging and dispersion on each pulse.

  In the determination information storage unit 15, determination criteria for identifying the motion state with respect to each pulse of the Doppler waveform information are statistically calculated based on past observation results and are stored in a database.

  FIG. 5 is an example of a determination information database stored in the determination information storage unit 15. In the example shown in FIG. 5, the fetal motion site, the maximum pulse velocity, the pulse velocity distribution, the pulse width, the pulse time distribution, the period between pulses, and the like are recorded as the determination criteria. In addition, as shown in the comment column, eyeball movements having different criteria for rapid movement and slow movement are set. A threshold range for determination is set for each determination criterion, and determination is performed based on whether or not the waveform determination parameter is included in the threshold range.

  Here, we briefly describe the relationship between fetal movement and cranial nerve function development. When the number of fetal eye movements is measured in units of one minute, an eye movement period in which one or more movements continue and an eye movement period in which no eye movement is measured are observed.

  Furthermore, in the eye movement period, the speed and duration of eye movement vary depending on whether the REM (Rapid Eye Movement) sleep state or the NREM (Non-Rapid Eye Movement) sleep state. In the REM sleep state, rapid eye movement is observed and slow eye movement coexists. In addition, since regular lip movement is observed during NREM sleep, lip movement is observed synchronously during the eye movement period.

  Next, a flow for counting the number of movements of the fetal region will be described using the flowchart of FIG. The measurement of the number of movements of a part is basic statistical information and is very important for determining the movement state of the part.

  First, in step ST61, a B-mode image is displayed on the monitor 6.

  In step ST62, a sampling point, preferably a reference point, is set at the same time as shown in FIG. 2 or FIG. When the sampling point and the reference point are set at the same time, the movement of the fetus can be detected by image processing by the position shift detection unit 144. Therefore, the position of the sampling point is corrected based on the amount of position shift of the reference point. Can do.

  In addition, information on which part of the fetus the set sampling point indicates (for example, an eyeball or a lip) is explicitly set. As a result, a determination criterion corresponding to the part can be read from the determination information storage unit 15 in a step described later.

  In step ST63, measurement is started in the Doppler mode, and Doppler waveform information 41 at the sampling points as shown in FIG. 4 is acquired.

  If the Doppler waveform information is not detected in step ST64 (ST64: No), it is confirmed whether the sampling point is set correctly. If the sampling point is shifted, it is set correctly and the fetal region motion is observed. It waits while seeing a B-mode image until it is done. If Doppler waveform information is detected (ST64: Yes), the process proceeds to step ST65, and a determination criterion for determining the motion state of the part is read from the determination information storage unit 15.

  In step ST66, the waveform determination parameter is extracted for each pulse of the Doppler waveform information, and the number of exercises is counted by comparing with the determination criterion acquired from the determination information storage unit 15, and this counting process is continued for the measurement time. To do. Step ST66 is roughly divided into count-up processing (ST661) and error processing (ST662). Details of this step will be described later.

  In step ST67, it is determined whether or not the measurement is completed. If it is within the measurement time (step ST67: No), the process returns to step ST66 to continue the pulse counting process. If the measurement is completed (step ST67: Yes), the pulse counts within the measurement time are counted and subjected to statistical processing (step ST68). In step ST69, the total result is stored in the total information storage unit 16, and the total unit 143 can further display the result according to the inspector's intention on the monitor 6 by further performing statistical processing on the total result. it can.

  FIG. 7 is a flowchart illustrating details of the count process and the error process. 8 to 10 show examples of various warning messages. First, the counting process in step ST661 will be described with reference to FIG.

  In step ST701, it is confirmed whether or not the fetus has moved during the counting process. Although this step can also be performed visually by the operator, the positional deviation detection unit 144 can automatically detect whether the reference point set in step ST62 is not shifted from the part on the image. . This movement detection includes the movement of the mother and the movement of the probe position by the operator. When the movement of the fetus is small, the position deviation detection unit 144 automatically sets the sampling point to the correct position. Adjustments can also be made.

  If the movement of the fetus is detected (ST701: No), the operator readjusts the sampling point and the reference point. If fetal movement is not detected and a pulse of Doppler waveform information is detected (ST701: Yes), waveform determination processing from step ST702 to step ST704 is performed for each pulse.

  In step ST702, it is determined whether or not the maximum speed of the pulse of the Doppler waveform information is within the threshold range of the criterion. This determination may be performed for each of plus and minus speeds, or the absolute value of plus and minus speeds may be obtained and the determination may be performed for the one with the larger absolute value. When the maximum pulse speed is within the threshold range of the determination criterion (step ST702: Yes), the process proceeds to the next determination step ST703.

  In step ST703, it is determined whether the pulse velocity distribution is within the threshold range of the determination criterion. Further, in step ST704, it is determined whether or not the pulse duration is within the threshold range of the criterion. As described above, by using a plurality of waveform determination parameters such as the maximum speed, speed distribution, and duration of each pulse, accuracy in determining the motion state of the part is improved. Note that a time distribution subjected to statistical processing may be used instead of the duration. Furthermore, a determination step using the pulse time interval or other statistical information as a waveform determination parameter may be added. Further, unnecessary steps may be skipped.

  If any of step ST702 to step ST704 is outside the threshold range of the criterion (steps ST702 to ST704: No), the process proceeds to error processing ST662. If any of steps ST702 to ST704 is within the threshold range of the determination criterion, it is determined as a region motion, and the count is incremented in step ST705. At the same time as counting up, the counted time, the type of part (eyeball, lips, etc.), and the type of movement state (rapid eye movement, slow eye movement, etc.) are recorded. The count-up process is continued until it is time to finish the measurement.

  The error process in step ST662 will be described. When the region movement cannot be determined from the Doppler waveform information in the count-up process in step ST661, the sampling points may be greatly shifted. In that case, the process returns to step ST62 and the sampling point is adjusted. At this time, as shown in FIG. 8, it is preferable to display a message such as “reconfirm the sampling point and reset it if the position is shifted”.

  In step ST706, it is determined whether or not the set measurement time has elapsed. If the measurement time has elapsed (step ST706: Yes), the pulse detection is terminated. If the measurement time has not ended, as shown in FIG. 9, a message such as “Would you like to stop observation although the predetermined observation time has not passed?” Is displayed on the monitor 6 and the judgment is operated. The user selects it (step ST707). If the operator stops the observation, the process proceeds to step ST708. In step ST708, a message such as “Do you want to discard the count? Do you want to calculate the predicted value?” As shown in FIG. 10 is displayed. When discarding the count measured so far (step ST708: Yes), the process proceeds to step ST710, and the count is discarded. When the operator does not discard the count and calculates the predicted value using the count value acquired so far (step ST709: Yes), the process proceeds to step ST711.

  In step ST711, a predicted value such as a pulse count value per predetermined time is calculated based on the data counted up to this time, and is stored in the total information storage unit 16.

  FIG. 11 is an example of a database stored in the total information storage unit 16. Field items include patient ID, site, pregnancy week, measurement date and time, measurement time, count number, expected count number, remarks, and the like. In FIG. 11, a database for the eyeball part and the lip part is described for the patient ID, Mr. A. The first record is data on eye movements at 38 weeks of gestation, and examination started on October 11, 2012 at 15:24. In addition, a diagnosis is made over a predetermined measurement time (here, 60 minutes). Detailed information is further folded in the first record, and the count number per minute of the measurement unit can be displayed. Furthermore, the result of every minute of the measurement unit is also folded (not shown), and the waveform judgment parameters set at the time of examination such as the time, pulse width, and maximum speed of counting up each pulse of the Doppler waveform information. The value can be stored and displayed.

  The second record is data in which the pregnancy week is 36 weeks, but the measurement time is 35 minutes, which is less than the predetermined measurement time (60 minutes). At this time, if No is selected in step ST709, a predicted value such as an expected count value per predetermined time is calculated and stored.

  The totaling unit 143 reads the database stored in the totaling information storage unit 16, performs various totaling, and displays the totaling result on the monitor 6. 12 to 14 are display examples of the total results.

  FIG. 12 is the result of eye movement over 60 minutes at 38 weeks of gestation. The horizontal axis represents time, and represents the number of eye movements in units of 1 minute. The eye movement can be observed from about 14 weeks of gestation, but from the time of passing 30 weeks of gestation, the eye movement period and the eye movement period are clearly distinguished and observed. Accordingly, it is inferred that the fetus is normally developing in the example of FIG.

  FIG. 13 also shows the results of eye movements at 38 weeks of gestation. The horizontal axis indicates the total frequency of the duration of the pulse width. The value of the waveform determination parameter (pulse width) used at the time of measurement is read from the database of the total information storage unit 16 and subjected to statistical processing. Thus, it is determined that both rapid eye movement and slow eye movement are observed, and it is assumed that REM sleep is occurring.

  FIG. 14 shows the transition of the eye movement with respect to the pregnancy week with reference to the past history. Thereby, it turns out that eye movement increases as the pregnancy week passes.

  Although lip movement is not shown, it is possible to determine whether NREM sleep is occurring by performing the same statistical processing as in FIG. As for lip movement, the period between pulses of the Doppler waveform information is also an important waveform determination parameter, and a large correlation with the eye movement period is obtained.

  As described above, according to the present embodiment, the sampling point is set at the fetal region whose movement is to be confirmed, the Doppler waveform information representing this region movement is acquired, and the region movement state is automatically detected for each pulse of the Doppler waveform information. Judgment can be made. For this reason, there is an effect that accurate and quick statistical processing can be performed compared to the conventional method of measuring the number of exercises while viewing moving image data recorded for a long time. As for eye movements, it is also possible to automatically distinguish between a plurality of movement states, rapid eye movements and slow eye movements.

(Second Embodiment)
In the first embodiment, the case where one sampling point is set has been described for convenience of explanation. When an array probe of a two-dimensional matrix is used for the ultrasonic probe 1, a plurality of sampling points can be set and scanned at the same time, and the multi-Doppler information can be obtained. In the present embodiment, the multi-Doppler information can be used to recognize the movement / rotation direction of the part and the correlation between different motion states.

  First, calculation of the movement direction and rotation direction of the eye movement will be described using the eyeball cross-sectional image of FIG. In the cross section of the eyeball of FIG. 2, it is assumed that the lateral movement of the crystalline lens 22 can be detected around the nose (not shown). When a two-dimensional matrix array probe is used as the ultrasonic probe 1, sampling points can be set on the same lens 22 as in FIG. 2 for an eyeball cross-sectional image in a direction perpendicular to FIG. Then, with respect to this sampling point, the vertical movement of the crystalline lens 22 can be detected with reference to the nose.

  That is, it can be identified whether the eyeball has moved up and down or left and right, and since multi-Doppler information at the same time is used, it is also possible to determine whether or not the eyeball is rotating. It is very important that the rotational movement of the eyeball in REM sleep can be determined. Also, if sampling points are set for the left and right eyeballs, the left and right eyeball movements can be compared.

  Next, the correlation between different motion states will be described with reference to FIG. Here, by simultaneously setting the sampling points 25E and 25M in the eyeball part 31 and the lip part 33, it becomes possible to add up the correlation between the eye movement and the lip movement in the same measurement time.

  Thus, when a plurality of sampling points are set at the same time, the counting unit 143 determines the movement state of each sampling point from the multi-Doppler information obtained from the plurality of sampling points, and associates them or different movement states. By calculating the correlation, it is possible to aggregate the detailed motion state.

  According to the second embodiment, since a plurality of sampling points can be set when an array probe of a two-dimensional matrix is used, it is possible to observe detailed movement states such as the movement direction and rotation of a part, and the movement states of different parts can be observed. There is also an effect that statistical processing can be performed simultaneously on the correlation.

  Although it is very difficult to directly acquire the electroencephalogram of a fetus that grows in the mother's womb with the current medicine, it is possible to evaluate the fetal brain development in detail by implementing this embodiment.

  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 eyeball movement and lip movement of the fetus have been described as main examples. However, the applied diagnosis is not limited to this. Needless to say, the present invention can be applied to the developmental state of the heart valve, and the eye movement can be applied to a newborn baby after delivery. In the above-described flowchart, the pulse count of the Doppler waveform information is described, but the present invention is not limited to this.

  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.

1 ... ultrasonic probe,
2 ... Transmitter / receiver,
3 ... Signal management processing unit,
4. Scan converter,
5 ... Additional information display section,
6 ... Monitor,
7: Image generation unit,
8 ... console,
9: Input control processing unit,
10 ... control unit,
14 ... Signal analysis processing unit,
15 ... determination information storage unit,
16 ... Total information storage unit,
141: Sampling position setting section,
142 ... motion detector,
143 ... Totaling department,
144: Position shift detection unit.

Claims (9)

A sampling position setting unit for setting a sampling point in a fetal region on an ultrasound image;
A motion detector that obtains Doppler waveform information obtained from the motion of the part set at the sampling point, and extracts a waveform determination parameter for each pulse of the Doppler waveform information;
A totaling unit that determines the motion state of the part set at the sampling point by comparing the waveform determination parameter and a determination criterion for determining the motion state, and totalizes the determination result as statistical information together with the waveform determination parameter; ,
A determination information storage unit for storing the determination criteria;
An aggregate information storage unit for holding the statistical information;
An ultrasonic diagnostic imaging apparatus. The waveform determination parameter includes a plurality of waveform information including maximum velocity information obtained for each pulse of Doppler waveform information, velocity distribution information, pulse width information, and a period between pulses,
The ultrasonic diagnostic imaging apparatus according to claim 1, wherein a statistical threshold range for determining an exercise state with respect to at least one waveform determination parameter is set for each of the regions as the determination criterion.   The ultrasonic diagnostic imaging apparatus according to claim 2, further comprising a determination criterion for each motion state in order to determine a plurality of motion states for the part.   The ultrasonic diagnostic imaging apparatus according to claim 1, wherein the fetal region is an eyeball portion, and the sampling point is set in a lens of an eyeball.   The ultrasonic diagnostic imaging apparatus according to claim 4, wherein the determination information storage unit includes a determination criterion for determining whether the eye movement is a rapid movement or a slow eye movement.   The ultrasonic diagnostic imaging apparatus according to claim 1, wherein the fetal region is a lip.   The ultrasonic image diagnostic apparatus according to claim 1, wherein the totaling unit displays the totaling information according to a pregnancy week and evaluates a brain development state of a fetus.   The ultrasonic apparatus according to claim 1, further comprising a position shift detection unit that detects a position shift of the fetal region, and corrects the position shift of the sampling point when the position shift of the fetal region is detected. .   When a plurality of sampling points are simultaneously set in the sampling position setting unit, the counting unit determines the movement state of each sampling point from multi-Doppler information obtained from a plurality of sampling points, and associates those movement states. The ultrasonic apparatus according to claim 1, wherein the detailed motion states are totaled by obtaining correlations between different motion states.

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