CN100418467C - Insertion support system - Google Patents

Abstract

According to an insertion support system of the present invention, when a biopsy area is specified at a periphery of the bronchi, the barycenter of the biopsy area is extracted. A circle centering on the barycenter is determined as a search area. The search area is expanded until the bronchi are located within the search area. A point in the search area to which the bronchi first reach is determined as an end point. A first route choice connecting the end point and a start point is determined. If the first route choice has not been registered yet, the first route choice is registered as a first registered route. Accordingly, a location of interest can be specified as an arbitrary region, and navigation leading to the specified region is appropriately set.

Description

Insert back-up system

Technical field

The present invention relates to support the insertion back-up system of the insertion of endoscope.

Background technology

Extensively adopt diagnosis in recent years, for example, wait the layer image of taking subject, in subject, obtain 3 d image data, use this 3 d image data to carry out the diagnosis of target site by utilizing X line CT (ComputedTomography) device based on image.

In the CT device, carry out roentgen radiation x/detection by rotating continuously on one side, carry subject continuously to the axon direction on one side, can in the 3D region of subject, carry out spiral helicine continuous sweep (helical scanning: helical scan), generate 3-D view according to the successive section layer image of 3D region.

The bronchial 3-D view that lung is arranged in a kind of image of this 3-D view.Bronchial 3-D view is used for three-dimensional position of grasping the abnormal portion that for example is suspect to be pulmonary carcinoma etc.And, in order to confirm abnormal portion, insert bronchus endoscope and stretch out biopsy needle and biopsy pliers etc. from leading section by biopsy, take the sample of organizing (sample).

In as bronchus, having the ramose pipeline in a plurality of stages, in the position of abnormal portion during near ramose tip, make the front end of endoscope accurately arrive relatively difficulty of target site at short notice, therefore for example in the spy of Japan opens 2000-135215 communique etc., a kind of device has been proposed, generate the three-dimensional image of described tested intravital pipeline according to the view data of the 3D region of subject, on described three-dimensional image, obtain the path that arrives objective along described pipeline, generate along the virtual interior video of the described pipeline in described path according to described view data, and show described virtual interior video, thereby bronchus endoscope is navigate to target site.

But, biological tissue as target site generally has certain scope, so the biopsy position when utilizing point to specify biopsy is also improper, a certain size target area is appointed as in expectation, but in device in the past, can not be appointed as this target area to the terminal point of navigation, have problem that can not determine the guidance path from the initial point to the target area.

Summary of the invention

The present invention In view of the foregoing proposes, and its purpose is to provide a kind of insertion back-up system, can specify at arbitrary region and be concerned about the position, and can set the navigation that arrives specified region rightly.

Insertion back-up system of the present invention constitutes to have: the virtual image generation unit, and it generates the virtual image on the described tested intravital body cavity pipeline according to the view data of the 3D region of subject; Path initial point setup unit, it is setting the initial point that endoscope leads to the insertion path on the described tested intravital body cavity pipeline on described virtual image; Be concerned about regional setup unit, it sets the zone at described tested intravital care position on described virtual image; The path termination extracting unit, it according to the zone at described care position, extracts the terminal point that described endoscope leads to the insertion path on the described tested intravital body cavity pipeline on described virtual image.

Insertion back-up system of the present invention has to specify at arbitrary region is concerned about the position, and can set the effect of the navigation that arrives specified region rightly.

Description of drawings

Fig. 1 is the structure chart that the bronchus of expression embodiments of the invention 1 is inserted the structure of back-up system.

Fig. 2 is the flow chart that the insertion supportive device of presentation graphs 1 generates the handling process of navigation data.

Fig. 3 is the 1st figure that is illustrated in unfolded path setting picture in the processing of Fig. 2.

Fig. 4 is the 2nd figure that is illustrated in unfolded path setting picture in the processing of Fig. 2.

Fig. 5 is the 3rd figure that is illustrated in unfolded path setting picture in the processing of Fig. 2.

Fig. 6 is the 4th figure that is illustrated in unfolded path setting picture in the processing of Fig. 2.

Fig. 7 is the 5th figure that is illustrated in unfolded path setting picture in the processing of Fig. 2.

Fig. 8 is the flow chart of the flow process handled of the path setting of presentation graphs 2.

Fig. 9 is the 1st figure of the processing of key diagram 8.

Figure 10 is the 2nd figure of the processing of key diagram 8.

Figure 11 is the 1st figure that is illustrated in unfolded path setting picture in the processing of Fig. 8.

Figure 12 is the 3rd figure of the processing of key diagram 8.

Figure 13 is the 2nd figure that is illustrated in unfolded path setting picture in the processing of Fig. 8.

Figure 14 is the 4th figure of the processing of key diagram 8.

Figure 15 is the 3rd figure that is illustrated in unfolded path setting picture in the processing of Fig. 8.

Figure 16 is illustrated in the figure that picture is supported in unfolded insertion in the processing of Fig. 2.

Figure 17 is the figure that is illustrated in the 1st variation of unfolded path setting picture in the processing of Fig. 8.

Figure 18 is the figure that is illustrated in the 2nd variation of unfolded path setting picture in the processing of Fig. 8.

Figure 19 is the structure chart that the bronchus of expression embodiments of the invention 2 is inserted the structure of back-up system.

Figure 20 is that expression insertion supportive device shown in Figure 19 generates the flow chart that inserts the handling process of supporting data.

Figure 21 is illustrated in the figure that unfolded patient information in the processing of Figure 20 is selected picture.

Figure 22 is the figure that is illustrated in unfolded path setting picture in the processing of Figure 20.

Figure 23 is the 1st figure of feature of the display packing of the explanation bronchus faultage image of Figure 22 and MPR image.

Figure 24 is the 2nd figure of feature of the display packing of the explanation bronchus faultage image of Figure 22 and MPR image.

Figure 25 is the 3rd figure of feature of the display packing of the explanation bronchus faultage image of Figure 22 and MPR image.

Figure 26 is the 4th figure of feature of the display packing of the explanation bronchus faultage image of Figure 22 and MPR image.

Figure 27 is the 1st flow chart of the flow process handled of the path setting of expression Figure 20.

Figure 28 is the 2nd flow chart of the flow process handled of the path setting of expression Figure 20.

Figure 29 is the 1st figure of explanation Figure 27 and processing shown in Figure 28.

Figure 30 is the 2nd figure of explanation Figure 27 and processing shown in Figure 28.

Figure 31 is the 3rd figure of explanation Figure 27 and processing shown in Figure 28.

Figure 32 is the 4th figure of explanation Figure 27 and processing shown in Figure 28.

Figure 33 is the 5th figure of explanation Figure 27 and processing shown in Figure 28.

Figure 34 is the 6th figure of explanation Figure 27 and processing shown in Figure 28.

Figure 35 is the 7th figure of explanation Figure 27 and processing shown in Figure 28.

Figure 36 is the 8th figure of explanation Figure 27 and processing shown in Figure 28.

Figure 37 is the 9th figure of explanation Figure 27 and processing shown in Figure 28.

Figure 38 is that expression utilizes the insertion of the insertion supportive device generation of Figure 19 to support the figure of picture.

Figure 39 is the structure chart that the bronchus of expression embodiments of the invention 3 is inserted the structure of back-up system.

Figure 40 is that the insertion supportive device of expression Figure 39 generates the flow chart that inserts the handling process of supporting data.

Figure 41 is illustrated in the figure that unfolded patient information in the processing of Figure 40 is selected picture.

Figure 42 is the figure that is illustrated in unfolded path setting picture in the processing of Figure 40.

Figure 43 is the 1st figure of feature of the display packing of the explanation bronchus image of Figure 42 and MPR image.

Figure 44 is the 2nd figure of feature of the display packing of the explanation bronchus image of Figure 42 and MPR image.

Figure 45 is the 3rd figure of feature of the display packing of the explanation bronchus image of Figure 42 and MPR image.

Figure 46 is the 4th figure of feature of the display packing of the explanation bronchus image of Figure 42 and MPR image.

Figure 47 is the 1st flow chart of the flow process handled of the path setting of expression Figure 40.

Figure 48 is the 2nd flow chart of the flow process handled of the path setting of expression Figure 40.

Figure 49 is the 1st figure of the processing of explanation Figure 47 and Figure 48.

Figure 50 is the 2nd figure of the processing of explanation Figure 47 and Figure 48.

Figure 51 is the 3rd figure of the processing of explanation Figure 47 and Figure 48.

Figure 52 is the 4th figure of the processing of explanation Figure 47 and Figure 48.

Figure 53 is the 5th figure of the processing of explanation Figure 47 and Figure 48.

Figure 54 is the 6th figure of the processing of explanation Figure 47 and Figure 48.

Figure 55 is the 7th figure of the processing of explanation Figure 47 and Figure 48.

Figure 56 is the 8th figure of the processing of explanation Figure 47 and Figure 48.

Figure 57 is the 9th figure of the processing of explanation Figure 47 and Figure 48.

Figure 58 is that expression utilizes the insertion of the insertion supportive device generation of Figure 39 to support the figure of picture.

The specific embodiment

Below, with reference to the description of drawings embodiments of the invention.

(embodiment 1)

As shown in Figure 1, the bronchus of present embodiment 1 insertion back-up system 1 is made of bronchus endoscope apparatus 3 and insertion supportive device 5.

Insert supportive device 5 generates bronchus inside according to the CT view data virtual interior video (below be expressed as the VBS image), and the endoscopic images that will obtain by bronchus endoscope apparatus 3 (below be expressed as real time imaging) is synthetic with the VBS image, and be presented on the monitor 6, carry out bronchus endoscope apparatus 3 thus to bronchial insertion support.

And, though bronchus endoscope apparatus 3 is not shown, but the light source of illumination light is provided and camera control unit of carrying out signal processing from bronchoscopic image pickup signal etc. is constituted by bronchoscope, for bronchoscope with image unit, bronchoscope is inserted in the intravital bronchus of patient, shooting bronchus inside, destination organization to the bronchus end carries out biopsy, and is presented on the monitor 7 real time imaging and VBS image are synthetic.

Monitor 7 is provided with the input part 8 that is made of touch screen, can simultaneously insert to handle and simultaneously easily operate the input part 8 that is made of touch screen.

Insert supportive device 5 by constituting with the lower part: the CT view data is taken into portion 11, (Magnetic Optical disk: magneto-optic disk) (Digital VersatileDisk: digital versatile disk [Sony]) device waits movably storage medium, is taken into the 3 d image data by the not shown known CT device generation of the x-ray tomography picture of taking the patient for device or DVD by MO for example for it; CT image data storage portion 12, its storage is taken into the CT view data that portion 11 is taken into by the CT view data; MPR image production part 13, it generates MPR image (multibreak face is the design of graphics picture again) according to the CT view data that is stored in the CT image data storage portion 12; Path setting portion 14, its generation has the path setting picture described later of the MPR image that MPR image production part 13 generated, and that sets bronchus endoscope apparatus 3 leads to bronchial support path (the following path that only is expressed as); As the VBS image production part 15 of virtual image generation unit, it is that unit generates the successive VBS image of being set by path setting portion 14 in path according to the CT view data that is stored in the CT image data storage portion 12 with the frame; VBS image storage part 16, the VBS image that its storage VBS image production part 15 generates; Image processing part 17 as the navigation picture generation unit, its input utilizes memorizer 20 to generate by the insertion described later of real time imaging, VBS image and a plurality of breviary VBS image construction and supports picture from the image pickup signal of bronchus endoscope apparatus 3 with from the input signal of input part 8; Pictorial display control part 18, picture is supported in the insertion that its monitor 6 is showed paths path setting picture that configuration part 14 generates and image processing part 17 generate; Input equipment 19, it is made of keyboard and the pointer device to path setting portion 14 input set informations.

Bronchus endoscope apparatus 3 receives VBS image and breviary VBS image from the image processing part 17 that inserts supportive device 5, synthetic with real time imaging, support the identical picture of picture showing on the monitor 7 with inserting the insertion that supportive device 5 is shown on the monitor 6, and the image processing part 17 of exporting to insertion supportive device 5 from the input information of the input part 8 that constitutes by touch screen of monitor 7.

In addition, CT image data storage portion 12 and VBS image storage part 16 can be made of a hard disk, and in addition, MPR image production part 13, path setting portion 14, VBS image production part 15 and image processing part 17 can be made of an arithmetic processing circuit.And, the CT view data be taken into portion 11 by MO or DVD etc. movably storage medium be taken into the CT view data, but at the CT device or when preserving in the hospital of CT view data server and connecting in the hospital LAN, also can constitute the CT view data and be taken into portion 11, be taken into the CT view data by LAN in the hospital by the interface circuit that can connect LAN in this hospital.

Effect to the present embodiment of such formation describes.

As shown in Figure 2, utilizing before bronchus endoscope apparatus 3 observes/dispose, insert supportive device 5 in step S1, be taken into the CT view data that portion 11 is taken into the patient who is generated by the CT device by the CT view data, in step S2 the CT image data storage that is taken in CT image data storage portion 12.

In step S3, make monitor 6 show path setting picture 21 shown in Figure 3 by path setting portion 14, select patient information in the patient information tab picture 22 on path setting picture 21.According to this selection, in step S4, generate selected patient's the MPR image that for example constitutes by 3 multibreak different pictures, in step S5, on path setting picture 21, show this MPR image 23a, 23b, 23c.In path setting picture 21, be provided with the VBS image display area 23d that shows the VBS image.

In addition, the selection of the patient information in the patient information tab picture 22 is undertaken by the patient ID that utilizes input equipment 19 input identification patients.

Then, in step S6, when utilizing input equipment 19 to select path setting label 24 (with reference to Fig. 3) on the path setting pictures 21, path setting label picture 25 shown in Figure 4 is presented on the path setting picture 21, carry out path setting described later and handle, set bronchoscope at intrabronchial insertion support path.

When having set the insertion support path, in step S7, be that unit generates the successive VBS image in all paths that sets with the frame by VBS image production part 15, in step S8, the VBS image that is generated is stored in the VBS image storage part 16.

By the processing of above-mentioned step S1～S8, finish the preparation of the insertion support of the insertion supportive device 5 when using bronchoscope observation/disposal.

Use Fig. 5～Fig. 8 that the path setting processing of above-mentioned steps S6 is described herein.

When having selected the route searching button in path setting picture 21, the path setting of beginning step S6 is handled.Specifically, the initial point input indication window 31 of the initial point in urgency input path shown in Figure 5 is presented on the path setting picture 21, is using setting initial point 71 on the layer image of cursor 30 in MPR image 23a, 23b, 23c on the path setting picture 21.After setting initial point 71, initial point 71 is also set in corresponding position on other two layer images of MPR image 23a, 23b, 23c, and the VBS image that shows initial point 71 on VBS image display area 23d, the terminal point of urgency set path shown in Figure 6 are that the biopsy regions input indication window 32 of biopsy regions 72 is presented on the path setting picture 21.

On the path setting picture 21 of this Fig. 6, use on the layer image of cursor 30 in MPR image 23 two dimension to draw biopsy regions 72 and set.The quantity of the biopsy regions 72 that set this moment is not limited to one, also can specify a plurality ofly, figure 6 illustrates the state of specifying two biopsy regions 72a, 72b.

And after the setting of biopsy regions 72 finished, the number of paths of the searching route quantity of each biopsy regions 72 of setting shown in Figure 7 was set window 33 and is presented on the path setting picture 21.By setting the searching route quantity of each biopsy regions 72, can search out the close path (approach route) of many bar navigations object in biopsy regions 72.

According to Fig. 5～Fig. 7, after having set initial point, biopsy regions 72 and searching route quantity, according to processing searching route shown in Figure 8.

That is, as shown in Figure 8, in step S11, detect the quantity of the biopsy regions 72 that sets, in step S12, read in searching route quantity n, in step S13, read in the position of initial point 71.

And, in step S14, extract the position of centre of gravity of biopsy regions 72, in step S15, r is made as Δ r after, in step S16, being that radius centered is that the region of search is appointed as in the round inside of r with the position of centre of gravity.

Whether in step S17, judging has bronchus in the region of search, when bronchus is arranged, in step S18, determines the path candidates of this position as terminal point.

After having determined path candidates, in step S19, judge whether determined path candidates is registered, under the situation that does not have registration, in step S20, generate pathname, and register as support path based on the branch point title from the initial point to the terminal point.

And, in step S21, judge that whether the number of paths of being registered is less than the number of paths n that reads in step S12.

In addition, in step S17, be judged as when not having bronchus in the region of search, when determined path candidates is registered in step S19, when perhaps registered number of paths is less than number of paths n in step S21, in step S22, r is made as r+ Δ r amplifies the region of search, and return step S16.

When registered number of paths reaches the number of paths n that reads in step S12, in step S23, judge whether to search for all biopsy regions 72 that set, if searched for all biopsy regions 72 then end process, when also having the biopsy regions 72 of not search, in step S24, extract the position of centre of gravity of next biopsy regions 72, and return step S15.

Specifically, as shown in Figure 9, during designated biopsy regions 72, extract the center of gravity 103 of biopsy regions 72 in the end of bronchus 101.

And, as shown in figure 10, the circle that is the center with this center of gravity 103 is made as region of search 104, amplify region of search 104 and be positioned at region of search 104 up to bronchus 101, the point that bronchus 101 is positioned at first region of search 104 is made as terminal point 105, as shown in figure 11, determines to connect the 1st path candidates 106 of initial point 71 and this terminal point 105, if the 1st path candidates 106 is still unregistered, then register as the 1st support path.The pathname of this moment is named according to the branch point title that will pass through.

After having determined the 1st support path, as shown in figure 12, increase is the radius of the region of search 104 at center with center of gravity 103, amplify region of search 104, after the bronchus point that is positioned at region of search 104 be made as terminal point 107, as shown in figure 13, determine to connect the 2nd path candidates 108 of initial point 71 and this terminal point 107, if the 2nd path candidates 108 is still unregistered, then register as the 2nd support path.In Figure 13, the 2nd path candidates 108 is different with the 1st support path among Figure 11, so the 2nd path candidates 108 becomes the 2nd support path.The pathname of this moment is also named according to the branch point title that will pass through.

In the present embodiment, because number of paths is 3, so after having determined the 2nd support path, identical ground, as shown in figure 14, further increasing with center of gravity 103 is the radius of the region of search 104 at center, amplifies region of search 104, and the point that bronchus afterwards is positioned at region of search 104 is made as terminal point 109, as shown in figure 15, determine to connect the 3rd path candidates 110 of initial point 71 and this terminal point 109,, then register as the 3rd support path if the 3rd path candidates 110 is still unregistered.In Figure 15, because the 3rd path candidates 110 is different with the 1st and the 2nd support path, so the 3rd path candidates 110 becomes the 3rd support path.The pathname of this moment is also named according to the branch point title that will pass through.

Like this, can set the support path of specified number of paths.All biopsy regions 72 are carried out these handle, each biopsy regions 72 is set the support path of specified number of paths.

Under the insertion support of inserting supportive device 5, when beginning the bronchus splanchnoscopy in the support path of setting like this, on monitor 7, show insertion support picture 51 as shown in figure 16.In addition, show on monitor 6 that also picture 51 is supported in 7 identical insertions with monitor.

This insertion supports that picture 51 comprises: show the endoscope real time image display area 52 from the real time imaging of bronchus endoscope apparatus 3; The VBS image display area 53 that shows VBS image 53a; The VBS image 53a of all branch points in path is dwindled the breviary VBS of the branch image-region 54 that is shown as the breviary VBS of branch image 54 (a)～54 (j), with the branch point corresponding virtual image at real time imaging place be that VBS image 53a is presented on the VBS image display area 53.

Herein, the frame of the branch breviary VBS image identical with VBS image 53a on being presented at VBS image display area 53 is shown as thick frame or colour, can distinguish with other the breviary VBS of branch image, it is that operative doctor can be discerned the VBS image that is presented on the VBS image display area 53 easily for which ramose image.

In addition, also can all support paths be simultaneously displayed on MPR image 23a, 23b, the 23c in the mode of distinguishing color according to as shown in Figure 17.And, on MPR image 23a, 23b, 23c, specify initial point and biopsy regions, but be not limited thereto, also can be as shown in figure 18, on path setting picture 21, show bronchial 3-D view 151, in 3-D view 151, specify initial point 71 and biopsy regions 72, to carry out route searching.

(embodiment 2)

As shown in figure 19, the bronchus of present embodiment 2 insertion back-up system 301 is made of bronchus endoscope apparatus 303 and insertion supportive device 305.

Insert supportive device 305 generates bronchus inside according to the CT view data virtual interior video (below be expressed as the VBS image), and the endoscopic images that will obtain by bronchus endoscope apparatus 303 (below be expressed as real time imaging) is synthetic with the VBS image, and be presented on the monitor 306, carry out bronchus endoscope apparatus 303 thus to bronchial insertion support.

And, though bronchus endoscope apparatus 303 is not shown, but the light source of illumination light is provided and camera control unit of carrying out signal processing from bronchoscopic image pickup signal etc. is constituted by bronchoscope, for bronchoscope with image unit, bronchoscope is inserted in the intravital bronchus of patient, shooting bronchus inside, destination organization to the bronchus end carries out biopsy, and is presented on the monitor 307 real time imaging and VBS image are synthetic.

Monitor 307 is provided with the input part 308 that is made of touch screen, can simultaneously insert to handle and simultaneously easily operate the input part 308 that is made of touch screen.

Insert supportive device 305 by constituting with the lower part: the CT view data is taken into portion 311, it waits movably storage medium by device of MO (Magnetic Optical disk) for example or DVD (Digital Versatile Disk) device, is taken into the 3 d image data by the not shown known CT device generation of the x-ray tomography picture of taking the patient; CT image data storage portion 312, its storage is taken into the CT view data that portion 311 is taken into by the CT view data; The regulation internal organs as the CT view data that internal organs extracting part 320, its extraction are stored in the CT image data storage portion 312 are the section (segmentation) of bronchial three-dimensional information; MPR image production part 313, it is according to the CT view data that is stored in the CT image data storage portion 312, generate MPR image (multibreak face is the design of graphics picture again), and the bronchial bronchus faultage image that overlapping demonstration internal organs extracting part 320 extracts on the MPR image; Path setting portion 314, its generation has the path setting picture described later of the MPR image of MPR image production part 313 generations, sets bronchus endoscope apparatus 303 and leads to bronchial support path (the following path that only is expressed as); VBS image production part 315, it is that unit generates the successive VBS image of being set by path setting portion 314 in path according to the CT view data that is stored in the CT image data storage portion 312 with the frame; VBS image storage part 316, the VBS image that its storage VBS image production part 315 generates; Image processing part 317, its input generates by the insertion described later of real time imaging, VBS image and a plurality of breviary VBS image construction and supports picture from the image pickup signal of bronchus endoscope apparatus 303 with from the input signal of input part 308; Pictorial display control part 318, picture is supported in the insertion that its monitor 306 is showed paths path setting picture that configuration part 314 generates and image processing part 317 generate; Input equipment 319, it is made of keyboard and the pointer device to path setting portion 314 input set informations.

Bronchus endoscope apparatus 303 receives VBS image and breviary VBS image from the image processing part 317 that inserts supportive device 305, and be presented on the monitor 307, and the input information from the input part 308 that is made of touch screen of monitor 307 is exported to the image processing part 317 that inserts supportive device 305 with real time imaging is synthetic.

In addition, CT image data storage portion 312 and VBS image storage part 316 can be made of a hard disk, and in addition, MPR image production part 313, path setting portion 314, VBS image production part 315 and image processing part 317 can be made of an arithmetic processing circuit.And, the CT view data be taken into portion 311 by MO or DVD etc. movably storage medium be taken into the CT view data, but at the CT device or when preserving in the hospital of CT view data server and connecting in the hospital LAN, also can constitute the CT view data and be taken into portion 311, be taken into the CT view data by LAN in the hospital by the interface circuit that can connect LAN in this hospital.

Effect to the present embodiment of such formation describes.

As shown in figure 20, utilizing before bronchus endoscope apparatus 303 observes/dispose, insert supportive device 305 in step S301, be taken into the CT view data that portion 311 is taken into the patient who is generated by the CT device by the CT view data, in step S302 the CT image data storage that is taken in CT image data storage portion 312.

In step S303, make monitor 306 show patient information selection picture 322 shown in Figure 21 by path setting portion 314, select to select patient information in the picture 322 at patient information.And, utilization selects patient information to select the path setting button 323 of picture 322 based on the pointer 324 of the operation of input equipment 319, thus, in step S304, in MPR image production part 313, generate selected patient's the MPR image 325 that for example constitutes by 3 multibreak different pictures, show path setting picture 326 shown in Figure 22 on monitor 306, this path setting picture 326 has by axial (axial) image 325a, crown (coronal) image 325b, the MPR image 325 that constitutes of (sagittal) image 325c radially, routing information picture 328 with the information of showing paths.

In addition, the patient information that carries out in path setting portion 314 is selected the selection of the patient information in the picture 322, is undertaken by the patient ID that utilizes input equipment 319 input identification patients.

Then, in step S305, utilizing internal organs extracting part 320 to extract the regulation internal organs that are stored in the CT view data in the CT image data storage portion 312 is bronchus, generate the bronchial bronchus faultage image 327 that is extracted, and export to MPR image production part 313, according to shown in Figure 22, the bronchial bronchus faultage image 327 that overlapping demonstration is extracted on MPR image 325.

In addition, the axial image 325a of MPR image 325, crown image 325b, radially each image of image 325c for example is made of black white image, will eclipsed bronchus faultage image 327 utilize the blue image image of diagonal line hatches part (in the Figure 22 for) to show, can visually distinguish the axial image 325a, the crown image 325b that show MPR image 325, radially each image and the bronchus faultage image 327 of image 325c.

Then, in step S306, on path setting picture 321, carry out path setting described later and handle, be set in the bronchoscopic insertion support path in the bronchus.

When having set the insertion support path, in step S307, be that unit generates the successive VBS image in all paths that sets with the frame by VBS image production part 315, in step S308, the VBS image that is generated is stored in the VBS image storage part 316.

By the processing of above-mentioned step S301～S308, finish the preparation of the insertion support of the insertion supportive device 305 when using bronchoscope observation/disposal.

Use Figure 22～Figure 26 that the feature of the display packing of eclipsed bronchus faultage image 327 shown in Figure 22 and MPR image 325 is described herein.

In the path setting picture 326 of Figure 22, use input equipment 319, set frame 330 by the transparency on the pointer 324 courses of action information areas 328, can set MPR image 325 and will eclipsed tube chamber internal organs extract result images be the separately transparency of bronchus faultage image 327 on monitor 306, and Figure 22 represents the transparency of MPR image 325 and bronchus faultage image 327 all is made as 0% o'clock demonstration example.

Specifically, in transparency setting frame 330, be provided with MPR image transparency increase and decrease button 330a and tube chamber internal organs and extract result images transparency increase and decrease button 330b, use input equipment 319, extract result images transparency increase and decrease button 330b by pointer 324 operation MPR image transparency increase and decrease button 330a and tube chamber internal organs, thereby can increase and decrease the transparency of MPR image 325 and bronchus faultage image 327.

Figure 23 is made as the transparency of MPR image 325 0%, the transparency of bronchus faultage image 327 is made as 50% o'clock demonstration example, and Figure 24 is made as the transparency of MPR image 325 0%, the transparency of bronchus faultage image 327 is made as 100% o'clock demonstration example.As Figure 22～shown in Figure 24, variable by the transparency that makes bronchus faultage image 327, that can carry out bronchus faultage image 327 on MPR image 325 emphasizes to show (Figure 22, Figure 23), and carries out the fusion that bronchus faultage image 327 is fused in the MPR image 325 is shown (Figure 24).

Figure 25 is made as the transparency of MPR image 325 50%, the transparency of bronchus faultage image 327 is made as 0% o'clock demonstration example, and Figure 26 is made as the transparency of MPR image 325 100%, the transparency of bronchus faultage image 327 is made as 0% o'clock demonstration example.As Figure 22, Figure 25 and shown in Figure 26, variable by the transparency that makes MPR image 325, can carry out on the MPR image 325 bronchus faultage image 327 emphasize to show (Figure 22, Figure 25), and only show that the bronchus of bronchus faultage image 327 shows (Figure 26) separately.

Like this, extract result images transparency increase and decrease button 330b by operation MPR image transparency increase and decrease button 330a and tube chamber internal organs, can increase and decrease the transparency of MPR image 325 and bronchus faultage image 327 arbitrarily, by extracting the result with the overlapping demonstration on MPR image 325 of the desired degree of emphasizing based on the bronchial tube chamber internal organs of CT view data is bronchus faultage image 327, can make operative doctor confirm bronchial position on the MPR image 325 in the process of normally observing MPR image 325.

In addition, be not limited to bronchus, for example can certainly be applied to utilize MPR image 325 to confirm the situation of the position of other tube chamber internal organs such as intestinal tube, biliary tract.

Below, illustrate that with reference to Figure 27～Figure 37 the path setting of the above-mentioned steps S306 of path setting portion 314 is handled.

As shown in figure 27, in step S321, on the MPR image, obtain the sign that bronchus is inserted the final position of supporting.Specifically, as shown in figure 29, for example when utilizing pointer 324 to click the axial image 325a of MPR image 325, demonstrate sign 400 in the position of being clicked.At this moment, at crown image 325b, radially the corresponding position on each image of image 325c also demonstrates sign 400.

Utilize pointer 324 select on the routing information zones 328 append button 411 time, path setting portion 314 obtains at axial image 325a, crown image 325b, the three-dimensional coordinate of appointed sign 400 on the image 325c radially.

Sign 400 is made of the index point 400a and the regional line 400b that represent the point that pointer 324 is clicked as shown in figure 30, and this zone line 400b represents to comprise the regulation zone of index point 400a, recognizes index point 400a so that can look on MPR image 325.Therefore, operative doctor is recognized regional line 400b, the position of acknowledgement indicator 400 easily by looking on MPR image 325.

And in step S322, whether judgement symbol 400 in bronchus, in the time of in bronchus, in step S323, registers to index point by in the tabulation.In the time of not in bronchus, in step S328, show affirmation window 440 shown in Figure 37.Operative doctor is when being assigned to index point the bronchus outside, if select "Yes", then index point promptly is registered to by in the tabulation.Be registered in and be endowed sequence number and demonstration in the register information zone 412 (with reference to Figure 29 and Figure 32) of three-dimensional coordinate on routing information zone 328 by the sign in the tabulation 400.

And, also can show some acknowledgement windows 405 that passes through shown in Figure 31.Should be bronchus of being used to confirm three dimensional display as the window of the sign 400 on 406 by an acknowledgement window 405, whether the operative doctor utilization be marked on the intrabronchial position of regulation by an acknowledgement window 405 judgement symbols 400.

And, repeatedly the sign 400 by point is registered to by the processing in the tabulation up to becoming desired position.

Figure 32 represents to have registered 5 by behind the point, utilizes to indicate 400 new states of specifying the 6th by point, and as illustrating on the MPR image 325 of Figure 32, registered 5 are passed through for example shown in green point of some 400a.In addition, in by some acknowledgement window 405, registered 5 by a some 400a for example shown in green point, the 6th by for example shown in red point of point 421.

In addition, when for example on the MPR of Figure 32 image 325, utilizing sign 400 to specify the 6th to pass through point, operative doctor is judged as and currently is marked on and is not suitable for utilizing last time bronchus as in the 406 specified bronchus of inserting support by a position during position by putting 421 by the acknowledgement window 405 that passes through shown in Figure 34, utilize pointer 324 to select delete button 414 on the routing information zone 328 of Figure 32, thereby can remove the appointment of sign 400.In addition, when selecting whole delete button 415, comprise that current all by point 421 are deleted by point.

Like this, as shown in figure 35 to pass through some acknowledgement window 405 such, during from terminal point 407 to the desired initial point 425 that begins to insert support, the desired point that passes through is registered in by in the tabulation, operative doctor need to judge whether the interpolation by point afterwards.

When having selected path interpolation button 416, the interpolation processing of in the step S326 of Figure 28, stipulating (for example passing through linear interpolation between the point).

In addition, in this interpolation processing, intrabronchial by point between with a plurality of virtual point of predetermined distance interpolation, carry out interpolation thus, but the interpolation of virtual point can be set arbitrarily in the interpolation interval box 417 (with reference to Figure 32) on the routing information zone 328 at interval.

And, in step S327, be registered in by in the tabulation by the path 430 that point constitutes of passing through that comprises virtual point.

But passing through of registering in step S327 a little may not be in bronchus.So under the situation of having implemented interpolation processing, after the processing of step S327, in step S329, deletion is not passed through point intrabronchial from tabulate by point, and end process, demonstrates path 430 in the acknowledgement window 405 in shown in Figure 36 passing through.

According to top described, when utilizing path setting portion 314 set paths 430, change the processing of the step S307 among Figure 20 over to.As mentioned above, in step S307, utilizing VBS image production part 315 is that unit generates the path 430 successive VBS images that set with the frame, in step S308 the VBS image that is generated is stored in the VBS image storage part 316.

About use the insertion supportive device 305 and the bronchus endoscope apparatus 303 that carry out path setting like this observe/insertion of insertion support usefulness when disposing supports picture, for the purpose of simplifying the description, is that 10 situation is that example describes with the branch point in path.

Under the insertion of inserting supportive device 305 is supported, during beginning bronchus splanchnoscopy, on monitor 306, show insertion support picture 451 as shown in Figure 38.

This insertion supports picture 451 by constituting with the lower part: show the endoscope real time image display area 452 from the real time imaging (not shown) of bronchus endoscope apparatus 303; The VBS image display area 453 that shows VBS image 453a; The VBS image 453a of all branch points in path is dwindled the breviary VBS of the branch image-region 454 that is shown as the breviary VBS of branch image 454 (a)～454 (j), the VBS image 453a of first branch point that on VBS image display area 453, shows paths, the breviary VBS of branch image 454 (a)～454 (j) of all branch points of demonstration on the breviary VBS of branch image-region 454.

In addition, on VBS image 453a, at the overlapping show navigator sign 455 in the path aperture place of advancing along the path.And, the frame of the branch breviary VBS image identical with VBS image 453a on being presented at VBS image display area 453 is shown as thick frame or colored box, can distinguish with other the breviary VBS of branch image, it is that operative doctor can easily be discerned the VBS image that is presented on the VBS image display area 453 for which ramose image.In first stage, the frame of the breviary VBS of branch image 454 (a) is shown as thick frame or colored box.

(embodiment 3)

As shown in figure 39, the bronchus of present embodiment 3 insertion back-up system 501 is made of bronchus endoscope apparatus 503 and insertion supportive device 505.

Insert supportive device 505 generates bronchus inside according to the CT view data virtual interior video (below be expressed as the VBS image), and the endoscopic images that will obtain by bronchus endoscope apparatus 503 (below be expressed as real time imaging) is synthetic with the VBS image, and be presented on the monitor 506, carry out bronchus endoscope apparatus 503 thus to bronchial insertion support.

And, though bronchus endoscope apparatus 503 is not shown, but the light source of illumination light is provided and camera control unit of carrying out signal processing from bronchoscopic image pickup signal etc. is constituted by bronchoscope, for bronchoscope with image unit, bronchoscope is inserted in the intravital bronchus of patient, shooting bronchus inside, destination organization to the bronchus end carries out biopsy, and is presented on the monitor 507 real time imaging and VBS image are synthetic.

Monitor 507 is provided with the input part 508 that is made of touch screen, can simultaneously insert to handle and simultaneously easily operate the input part 508 that is made of touch screen.

Insert supportive device 505 by constituting with the lower part: the CT view data is taken into portion 511, it waits movably storage medium by device of MO (Magnetic Optical disk) for example or DVD (Digital Versatile Disk) device, is taken into the 3 d image data by the not shown known CT device generation of the x-ray tomography picture of taking the patient; CT image data storage portion 512, its storage is taken into the CT view data that portion 511 is taken into by the CT view data; The regulation internal organs as the CT view data that internal organs extracting part 520, its extraction are stored in the CT image data storage portion 512 are the section of bronchial three-dimensional information; MPR image production part 513, it is according to the CT view data that is stored in the CT image data storage portion 512, generate MPR image (multibreak face is the design of graphics picture again), and the bronchial bronchus faultage image that overlapping demonstration internal organs extracting part 520 extracts on the MPR image; Path setting portion 514, its generation has the path setting picture described later of the MPR image of MPR image production part 513 generations, sets bronchus endoscope apparatus 503 and leads to bronchial support path (the following path that only is expressed as); VBS image production part 515, it is that unit generates the successive VBS image of being set by path setting portion 514 in path according to the CT view data that is stored in the CT image data storage portion 512 with the frame; VBS image storage part 516, the VBS image that its storage VBS image production part 515 generates; Image processing part 517, its input generates by the insertion described later of real time imaging, VBS image and a plurality of breviary VBS image construction and supports picture from the image pickup signal of bronchus endoscope apparatus 503 with from the input signal of input part 508; Pictorial display control part 518, picture is supported in the insertion that its monitor 506 is showed paths path setting picture that configuration part 514 generates and image processing part 517 generate; Input equipment 519, it is made of keyboard and the pointer device to path setting portion 514 input set informations.

Bronchus endoscope apparatus 503 receives VBS image and breviary VBS image from the image processing part 517 that inserts supportive device 505, and be presented on the monitor 507, and the input information from the input part 508 that is made of touch screen of monitor 507 is exported to the image processing part 517 that inserts supportive device 505 with real time imaging is synthetic.

In addition, CT image data storage portion 512 and VBS image storage part 516 can be made of a hard disk, and in addition, MPR image production part 513, path setting portion 514, VBS image production part 515 and image processing part 517 can be made of an arithmetic processing circuit.And, the CT view data be taken into portion 511 by MO or DVD etc. movably storage medium be taken into the CT view data, but at the CT device or when preserving in the hospital of CT view data server and connecting in the hospital LAN, also can constitute the CT view data and be taken into portion 511, be taken into the CT view data by LAN in the hospital by the interface circuit that can connect LAN in this hospital.

Effect to the present embodiment of such formation describes.

As shown in figure 40, utilizing before bronchus endoscope apparatus 503 observes/dispose, insert supportive device 505 in step S501, be taken into the CT view data that portion 511 is taken into the patient who is generated by the CT device by the CT view data, in step S502 the CT image data storage that is taken in CT image data storage portion 512.

In step S503, make monitor 506 show patient information selection picture 522 shown in Figure 41 by path setting portion 514, select to select patient information in the picture 522 at patient information.And, utilization selects patient information to select the path setting button 523 of picture 522 based on the pointer 524 of the operation of input equipment 519, thus, in step S504, in MPR image production part 513, generate selected patient's the MPR image that for example constitutes by 3 multibreak different pictures, show path setting picture 526 shown in Figure 42 on monitor 506, this path setting picture 526 has by axial image 525a, crown image 525b, radially the MPR image 525 that constitutes of image 525c and the routing information picture 528 of the information that shows paths.

In addition, the patient information that carries out in path setting portion 514 is selected the selection of the patient information in the picture 522, is undertaken by the patient ID that utilizes input equipment 519 input identification patients.

Then, in step S505, utilizing internal organs extracting part 520 to extract the regulation internal organs that are stored in the CT view data in the CT image data storage portion 512 is bronchus, generate the bronchial bronchus faultage image 527 that is extracted, and export to MPR image production part 513, according to shown in Figure 42, the bronchial bronchus faultage image 527 that overlapping demonstration is extracted on MPR image 525.

In addition, the axial image 525a of MPR image 525, crown image 525b, radially each image of image 525c for example is made of black white image, will eclipsed bronchus faultage image 527 utilize the blue image image of diagonal line hatches part (in the Figure 42 for) to show, can visually distinguish the axial image 525a, the crown image 525b that show MPR image 525, radially each image and the bronchus faultage image 527 of image 525c.

Then, in step S506, on path setting picture 521, carry out path setting described later and handle, be set in the bronchoscopic insertion support path in the bronchus.

When having set the insertion support path, in step S507, be that unit generates the successive VBS image in all paths that sets with the frame by VBS image production part 515, in step S508, the VBS image that is generated is stored in the VBS image storage part 516.

By the processing of above-mentioned step S501～S508, finish the preparation of the insertion support of the insertion supportive device 505 when using bronchoscope observation/disposal.

Use Figure 42～Figure 46 that the feature of the display packing of eclipsed bronchus image 527 shown in Figure 42 and MPR image 525 is described herein.

In path setting picture 526 shown in Figure 42, use input equipment 519, set frame 530 by the transparency on the pointer 524 courses of action information areas 528, can set MPR image 525 and will eclipsed tube chamber internal organs extract result images be separately the transparency of bronchus faultage image 527 on monitor 506, and Figure 42 represents the transparency of MPR image 525 and bronchus faultage image 527 all is made as 0% o'clock demonstration example.

Specifically, in transparency is set frame 530, be provided with MPR image transparency increase and decrease button 530a and tube chamber internal organs and extract result images transparency increase and decrease button 530b, use input equipment 519, extract result images transparency increase and decrease button 530b by pointer 524 operation MPR image transparency increase and decrease button 530a and tube chamber internal organs, thereby can increase and decrease the transparency of MPR image 525 and bronchus faultage image 527.

Figure 43 is made as the transparency of MPR image 525 0%, the transparency of bronchus faultage image 527 is made as 50% o'clock demonstration example, and Figure 44 is made as the transparency of MPR image 525 0%, the transparency of bronchus faultage image 527 is made as 100% o'clock demonstration example.As Figure 42～shown in Figure 44,, can on MPR image 525, emphasize or merge bronchus faultage image 527 by changing the transparency of bronchus faultage image 527.

Figure 45 is made as the transparency of MPR image 525 50%, the transparency of bronchus faultage image 527 is made as 0% o'clock demonstration example, and Figure 46 is made as the transparency of MPR image 525 100%, the transparency of bronchus faultage image 527 is made as 0% o'clock demonstration example.As Figure 42, Figure 45 and shown in Figure 46, variable by the transparency that makes MPR image 525, can only carry out the demonstration of bronchus faultage image 527.

Like this, extract result images transparency increase and decrease button 530b by operation MPR image transparency increase and decrease button 530a and tube chamber internal organs, can increase and decrease the transparency of MPR image 525 and bronchus faultage image 527 arbitrarily, by extracting the result with the overlapping demonstration on MPR image 525 of the desired degree of emphasizing based on the bronchial tube chamber internal organs of CT view data is bronchus faultage image 527, can make operative doctor confirm bronchial position on the MPR image 525 in the process of normally observing MPR image 525.

Below, illustrate that with reference to Figure 47～Figure 57 the path setting of the above-mentioned steps S506 in the path setting portion 514 is handled.

As shown in figure 47, in step S521, on the MPR image, obtain the sign that bronchus is inserted the final position of supporting.Specifically, as shown in figure 49, when for example utilizing pointer 524 to click the axial image 525a of MPR image 525, demonstrate sign 600 in the position of being clicked.At this moment, at crown image 525b, radially the corresponding position on each image of image 525c also demonstrates sign 600.

Utilize pointer 524 select on the routing information zones 528 append button 611 time, path setting portion 514 obtains at axial image 525a, crown image 525b, the three-dimensional coordinate of specified sign 600 on the image 525c radially.

Sign 600 is made of the index point 600a and the regional line 600b that represent the point that pointer 524 is clicked as shown in figure 50, and this zone line 600b represents to comprise the regulation zone of index point 600a, recognizes index point 600a so that can look on MPR image 525.Therefore, operative doctor is recognized regional line 600b, the easily position of acknowledgement indicator 600 by looking on MPR image 525.

And in step S522, whether judgement symbol 600 when in bronchus, in step S523, registers to index point by in the tabulation in bronchus.When not in bronchus, in step S528, show the affirmation window 640 shown in Figure 57.Operative doctor is when being assigned to index point the bronchus outside, if select "Yes", then index point is registered to by in the tabulation.Be registered in and be endowed sequence number and demonstration in the register information zone 612 (with reference to Figure 49 and Figure 52) of three-dimensional coordinate on routing information zone 528 by the sign in the tabulation 600.

And, also can show the some acknowledgement windows 605 that passes through shown in Figure 51.Should be bronchus of being used to confirm three dimensional display as the window of the sign 600 on 606 by an acknowledgement window 605, whether the operative doctor utilization be marked on the intrabronchial position of regulation by an acknowledgement window 605 judgement symbols 600.

And, repeatedly the sign 600 by point is registered to by putting processing in the obvious table up to becoming desired position.

Figure 52 represents to have registered 5 by behind the point, utilizes to indicate 600 new states of specifying the 6th by point, and as illustrating on the MPR image 525 of Figure 52, registered 5 are passed through for example shown in green point of some 600a.In addition, in by some acknowledgement window 605, registered 5 by a some 600a for example shown in green point, the 6th by for example shown in red point of point 621.

In addition, when for example on the MPR of Figure 52 image 525, utilizing sign 600 to specify the 6th to pass through point, operative doctor is judged as and currently is marked on and is not suitable for utilizing last time bronchus as in the 606 specified bronchus of inserting support by a position during position by putting 621 by the acknowledgement window 605 that passes through shown in Figure 54, utilize pointer 524 to select delete button 614 on the routing information zone 528 of Figure 52, thereby can remove the appointment of sign 600.In addition, when selecting whole delete button 615, comprise that current all by point 621 are deleted by point.

Like this, shown in Figure 55 to pass through some acknowledgement window 605 such, during from terminal point 607 to the desired initial point 625 that begins to insert support, the desired point that passes through is registered in by in the tabulation, operative doctor need to judge whether the interpolation by point then.

When having selected path interpolation button 616, the interpolation processing of stipulating among the step S526 in Figure 48 (for example between by point, carrying out linear interpolation).

In addition, in this interpolation processing, intrabronchial by point between with a plurality of virtual point of predetermined distance interpolation, carry out interpolation thus, but the interpolation of virtual point can be set arbitrarily in the interpolation interval box 617 on the routing information zone 528 at interval.

And, in step S527, be registered in by in the tabulation by the path 630 that point constitutes of passing through that comprises virtual point.

But passing through of registering in step S527 a little may not be in bronchus.So under the situation of having implemented interpolation processing, after the processing of step S527, in step S529, deletion is not passed through point intrabronchial from tabulate by point, and end process, demonstrates path 630 at the acknowledgement window 605 that passes through shown in Figure 56.

According to top described, when utilizing path setting portion 514 set paths 630, change the processing of the step S507 among Figure 40 over to.As mentioned above, in step S507, utilizing VBS image production part 515 is that unit generates the path 630 successive VBS images that set with the frame, in step S508 the VBS image that is generated is stored in the VBS image storage part 516.

About use the insertion supportive device 505 and the bronchus endoscope apparatus 503 that carry out path setting like this observe/insertion of insertion support usefulness when disposing supports picture, for the purpose of simplifying the description, is that 10 situation is that example describes with the branch point in path.

Under the insertion of inserting supportive device 505 is supported, during beginning bronchus splanchnoscopy, on monitor 506, show insertion support picture 651 such shown in Figure 58.

This insertion supports picture 651 by constituting with the lower part: show the endoscope real time image display area 652 from the real time imaging (not shown) of bronchus endoscope apparatus 503; The VBS image display area 653 that shows VBS image 653a; The VBS image 653a of all branch points in path is dwindled the breviary VBS of the branch image-region 654 that is shown as the breviary VBS of branch image 654 (a)～654 (j), the VBS image 653a of first branch point that on VBS image display area 653, shows paths, the breviary VBS of branch image 654 (a)～654 (j) of all branch points of demonstration on the breviary VBS of branch image-region 654.

In addition, on VBS image 653a, at the overlapping show navigator sign 655 in the path aperture place of advancing along the path.And, the frame of the branch breviary VBS image identical with VBS image 653a on being presented at VBS image display area 653 is shown as thick frame or colored box, can distinguish with other the breviary VBS of branch image, it is that operative doctor can easily be discerned the VBS image that is presented on the VBS image display area 653 for which ramose image.In first stage, the frame of the breviary VBS of branch image 654 (a) is shown as thick frame or colored box.

Like this, in the present embodiment, during from intrabronchial terminal point to initial point, specify passing through a little of desired interval, to specified terminal point-by between the point, by between the point, by carrying out interpolation processing between point-initial point, come set path, so can calculate the most suitable path (insertion support path) that the endoscope of (objective) inserts from the initial point to the terminal point along intrabronchial pipeline.

The invention is not restricted to the foregoing description, can in the scope that does not change aim of the present invention, carry out various changes, change etc.

Claims (3)

1. one kind is inserted back-up system, it is characterized in that having:

The virtual image generation unit, it generates the virtual image on the described tested intravital body cavity pipeline according to the view data of the 3D region of subject;

Path initial point setup unit, it is setting the initial point that endoscope leads to the insertion path on the described tested intravital body cavity pipeline on described virtual image;

Be concerned about regional setup unit, it sets the zone at described tested intravital care position on described virtual image;

The path termination extracting unit, it according to the zone at described care position, extracts the terminal point that described endoscope leads to the insertion path on the described tested intravital body cavity pipeline on described virtual image.

2. insertion back-up system according to claim 1 is characterized in that, described path termination extracting unit has:

Calculate the center of gravity calculation unit of center of gravity in the zone at described care position;

Extract the position extracting unit that is positioned near the position of described center of gravity on the described body cavity pipeline.

3. insertion back-up system according to claim 2 is characterized in that, described position extracting unit extracts near the position described center of gravity of being positioned on a plurality of described body cavity pipelines.

Images