The present invention relates to an ultrasonic diagnostic apparatus and the IMT (Intima-Media Thickness) measuring method therefore capable of measuring the IMT of an object to be examined.
IMT measurement is known as being effective for detection of arterial sclerosis by acquiring an ultrasonic image of a carotid artery in an object to be examined and measuring the IMT on the acquired ultrasonic image. In IMT measurement, an operator sets a region of interest (ROI) on an ultrasonic image, extracts a lumen side boundary and an outer-membrane side boundary of an intima-media complex in a set ROI, and calculates the distance between the extracted boundaries.
An example of IMT measurement is disclosed in Non-Patent Document 1. In the method disclosed in Non-Patent Document 1, an operator first operates an ultrasonic diagnostic apparatus to obtain an ultrasonic image of a carotid artery portion in an object. Next, a processor cuts out a region including the carotid artery portion, and generates a blurred image. Then the processor executes the binarization process on the blurred image and extracts the carotid artery region. The processor further extracts an edge portion for extracting a contour from the carotid artery region. The processor then applies the snake method on the extracted edge portion, and extracts the contour of the intima-media and outer membranes in the carotid artery region by generating contour lines using the B-spline interpolation.
Non-Patent Document 1: C. P. Loizou et al. “Snakes based segmentation of the common carotid artery intima media”, Med Bio Eng Comput (2007) 45:35-49
However, lowering of accuracy in boundary extraction at the time of IMT measurement attributed to interfusion of noise still remains as a problem even in Non-Patent Document 1.
For example, there are cases that noise content such as artifacts or speckle noise which is unique to ultrasonic waves generated from a lumen of a blood vessel or the outside of an outer membrane interfuses on the lumen-side boundary or the outer-membrane side boundary at the time of IMT measurement, thus IMT measurement with high accuracy cannot be achieved unless determination is made whether the pixel on the boundary is a signal or noise.
The objective of the present invention is to provide the ultrasonic diagnostic apparatus and the IMT measurement method capable of restraining influence of noise in boundary extraction at the time of IMT measurement.
In order to achieve the above-described objective, the ultrasonic diagnostic apparatus of the present invention is characterized in comprising:
Also, the IMT measurement method of the ultrasonic diagnostic apparatus related to the present invention is characterized in including:
As described above, in accordance with the ultrasonic diagnostic apparatus and the IMT measurement method of the present invention, it is possible to restrain the influence of noise in boundary extraction at the time of IMT measurement, since an ultrasonic image of a carotid artery portion of an object is obtained by an imaging unit, parting lines for segmenting the ultrasonic image into multiple regions are calculated by setting at least one threshold value by a parting line calculation unit, the direction for searching the multiple regions is specified, the intima-media region in the specified direction is searched based on the brightness, multiple curves are drawn from the information acquired by the search and positional information of the carotid artery portion in the ultrasonic image, and the intima-media thickness is calculated based on the distance between the drawn curves by an intima-media thickness calculation unit.
In accordance with the present invention, it is possible to provide the ultrasonic diagnostic apparatus and the IMT measurement method capable of restraining the influence of noise in boundary extraction at the time of IMT measurement.
Preferable embodiments of the ultrasonic diagnostic apparatus and the INT measurement method related to the present invention will be described below referring to the attached diagrams. In the following description, the same function parts are represented by the same reference numerals, and the duplicative description thereof is omitted.
In the first embodiment, region segmentation is performed by three values. Also, the first embodiment exemplifies the case that, in the ultrasonic image including a carotid region which is inputted at the timing synchronized with the biological signals, the lumen side boundary and the outer-membrane side boundary of an intima-media complex are extracted, and the IMT value is measured, displayed and outputted. Also in the present embodiment, the signals are of the brightness in the ultrasonic image, and the extraction position is the posterior wall of a carotid artery.
The ultrasonic diagnostic apparatus comprises an ultrasonic probe 3, an ultrasonic transmission/reception unit 4, an ultrasonic signal generation unit 5, an ultrasonic image generation unit 6, a biosignal extraction unit 7, an ROI setting unit 8, a desnoising unit 9, a region segmentation unit 10, a boundary correction unit 11, a boundary extraction unit 12, an IMT calculation unit 13, an output unit 14, an input unit 15 and a control unit 16.
An ultrasonic probe 3 transmits ultrasonic waves to a target portion of an object 2 from transducers and receives the reflected echo signals from the object 2. There are three kinds of ultrasonic probe 3 that are a linear type, a convex type and a sector type depending on the intended use.
The ultrasonic transmission/reception unit 4 drives the ultrasonic probe 3 for executing transmission, switches the circuit from the state of transmission to reception for the ultrasonic probe 3 to execute reception, and transmits the reflected echo signals received by the ultrasonic probe 3 to the ultrasonic signal generation unit 5.
the ultrasonic signal generation unit 5 executes signal processing on the reception signal from the ultrasonic transmission/reception unit 4 according to the imaging setting set by the input unit 15 via a phasing circuit or an amplifying circuit so as to obtain a phased ultrasonic signal.
The ultrasonic image generation unit 6 generates an ultrasonic image from the signals inputted from the ultrasonic signal generation unit 5 based on the imaging setting set via the input unit 15.
The biosignal extraction unit 7 extracts biosignals of the object 2 and converts them into electrical signals. There are biosignals such as an ECG (electrocardiogram) or a PCG (phonocardiogram).
The ROI setting unit 8 sets an ROI on the signals in the ultrasonic image generated by the ultrasonic image generation unit 6. The ROI is manually set by an examinee using the input unit 15. Also, there are cases that the ROI is set in a computer program as disclosed, for example in JP-A-H11-155862. The case that the ROI is set in a computer is referred to as automatic setting of ROI.
The denoising unit 9 eliminates speckle noise, acoustic noise and heat noise that are overlapped on an image. Denoising improves extraction accuracy of the boundary extraction unit 12 by smoothing brightness variation of an image.
The region segmentation unit 10 calculates parting lines to be the boundary positions for the three regions of a lumen region, an intima-media region and an outer-membrane region or the two regions of a lumen side region and an outer-membrane side region, by the method for acquiring a threshold value based on the brightness distribution of an ROI.
The boundary correction unit 11 corrects the positions of boundaries in the boundary extraction unit 12 from the parting lines calculated by the region segmentation unit 10.
The boundary extraction unit 12 extracts a lumen side boundary and an outer-membrane side boundary based on the positions of the parting lines. For example, the boundary extraction unit 12 extracts the lumen side boundary in the range limited from the lumen side parting line to the lumen side as well as the outer-membrane side boundary in the range limited from the outer-membrane side parting line to the outer-membrane side.
The IMT calculation unit 13 calculates the distance between the lumen side boundary and the outer-membrane side boundary as the IMT value. The IMT calculation unit 13 further calculates the statistics such as the average value, the maximum value and the minimum value of the IMT values in the ROI.
The output unit 14 is a device such as a monitor which displays boundaries or measured values on a screen and a printer which outputs the displayed content on a measurement report. The monitor is an output device such as a CRT, liquid crystal monitor, plasma monitor or organic EL monitor for displaying information such as images, letters and graphics.
Input unit 15 is an interface for manual operation of measurement condition setting or ROI setting in IMT measurement by an ultrasonic diagnostic apparatus, and an input device such as a keyboard, trackball, switch and dial.
The control unit 16 controls the entire system and the execution timing of IMT measurement or the operation timing of the output unit 14 using the timing of the biosignals outputted from the biosignal extraction unit 7. For example, a CPU is used as the control unit 16.
Therefore, the ultrasonic probe 3, the ultrasonic transmission/reception unit 4, the ultrasonic signal generation unit 5 and the ultrasonic image generation unit 6 function as an imaging unit for obtaining an ultrasonic image of a carotid artery portion in an object.
Also, they function as a parting-line calculation unit for calculating parting lines for segmenting the ultrasonic image into multiple regions by setting at least one threshold value.
Also, the biosignal extraction unit 7, the ROI setting unit 8, the denoising unit 9, the region segmentation unit 10, the boundary correction unit 11, the boundary extraction unit 12, the IMT calculation unit 13, the output unit 14, the input unit 15 and the control unit 16 function as an intima-media thickness calculation unit. The intima-media thickness calculation unit specifies the direction for searching the multiple regions, searches an intima-media region in the specified direction based on the brightness, draws multiple curves from the information acquired by the search and positional information of the carotid artery portion in the ultrasonic image and calculates the intima-media thickness based on the distance between the multiple curves. In the present embodiment, two directions are specified for searching the multiple regions.
Next, an operation example of the present embodiment will be described referring to the diagrams.
In
An examiner obtains an ultrasonic image including a carotid artery region by applying the ultrasonic probe 3 on a cervical region of the object 2. There are cases that the ultrasonic image including a carotid artery is referred to as merely an image (step 101: imaging of carotid artery image).
The examiner sets the measurement timing using the input unit 14. The setting example of measurement timing may be performed by setting an ECG as a biosignal and executing IMT measurement process for each R-wave of the ECG. Also, another setting example of measurement timing may be performed by setting time intervals of IMT measurement. In
Next, the control unit 16 obtains an image at the set measurement timing from the images outputted from the ultrasonic image generation unit 6. The obtained image is displayed on the output unit 14 as image 202 in
Next, the examiner sets an ROI at the target position for IMT measurement on the carotid artery image 202 using the ROI setting unit 8. It is desirable to set an ROI at the position having less noise where the signal intensity of the lumen, the intima-media complex and the outer membrane is displayed continuously in the longitudinal direction of the blood vessel as well as stepwise in two steps in the short-axis direction thereof. Given this factor, the examiner sets an ROI using the input unit 15 while variably adjusting its size and position on the carotid artery image. While the shape of an ROI is set as a rectangle here, a circular shape or other shapes may be applied as long as it can be defined as a region. The automatic ROI setting method may also be used (step 104: setting of ROI).
Next, the control unit 16 causes the denoising unit 9 to eliminate variation of the brightness value attributed to speckle noise, acoustic noise and heat noise overlapped on the image brightness value in the ROI. Concrete examples of denoising process will be described using
Also, fine noises attributed to heat can be eliminated by applying a smoothing filter such as a moving-average filter (step 105: denoising)
Next, the control unit 16 segments the intima-media region using the image brightness value within the ROI by the region segmentation unit 10, and extracts the parting lines. Extraction of the parting lines will be described using
Given this factor, the region segmentation method for segmenting into three regions of lumen side region Reg1, intima-media region Reg2 and outer-membrane region Reg3 will be described. In
Also, the position where the brightness value from intima-media region Reg2 to outer-membrane region Reg3 changes is set as an outer-membrane side parting line 23. As for the threshold value calculation, the method such as calculating the minimum value, the percentile method and the discriminant analysis method can be applied. The percentile method sets the threshold value so that the pixel number ratio between the 0-part and a part of a binarized or multi-valued image becomes p:1−p. Also, the discriminant analysis method determines the threshold so that the between-class variation of each region becomes the maximum when an image is binalized or muti-valued.
Given this factor, the control unit 16 calculates magnitude correlation between the area of lumen region Reg1, intima-media region Reg2 and outer-membrane region Reg3 and the area of noise N. Further, the control unit 16 eliminates noise N while remaining lumen region Reg1, intima-media region Reg2 and outer-membrane region Reg3 having large areas. In this manner, noise N is eliminated as shown in
Next, the control unit 16 causes the boundary correction unit 11 to correct the positions of parting lines as shown in the examples of
Further, the control unit 16, in the case that the calculated distance is larger than the reference value, replaces the position of lumen side parting line 12 with the position of approximated curve L12ap of the lumen side parting line and sets it as corrected curve L12adj of the lumen side parting line. The reference value is inputted by an examiner via the input unit 15, and stored by the control unit 16 in a device such as a memory which is not shown in the diagram to be used for control operation. The part where lumen side parting line L12 and approximated line L12ap of the lumen side parting line are separated as shown in
Next, the controller 16 causes the boundary extraction unit 12 to extract the lumen side boundary and the outer side boundary of inner-media region Reg2.
Next, the controller 16 causes the boundary correction unit 11 to correct the positions of the lumen side boundary and the outer-membrane side boundary. The correction method is the same as the correction method of parting lines in step 107.
Next, the control unit 16 causes the IMT calculation unit 13 to calculate the IMT value based on the distance between boundaries L12pr and L23pr. The IMT value is calculated as the distance between the lumen side boundary and the outer-membrane side boundary. As for the calculation values, the average value of an entire INT boundary, the maximum value, the minimum value, the values of the left end, the center and the right end of the ROI or the average value of the left end, the center and the right end of the ROI are acquired (step 110: calculation of IMT value).
Next, the control unit 16 causes the output unit 14 to display the boundaries or the IMT measurement values on the display screen 201. Lumen side boundary 207 and outer-membrane side boundary 208 are displayed by being superimposed on the ROI 206 in the carotid artery image 202. The dotted lines indicating the left end, the center and the right end of the ROI, are displayed in ROI 206 so that the examinee can move them to the left and the right using an input device. The maximum value and the minimum value of the IMT value are displayed by marking the positions at the values thereof. For example, the marks are displayed at position 212 where the maximum value is and at position 213 where the minimum value is while being superimposed on the ROI 206. The measurement values are displayed by tabular form 203. The IMT value is displayed on graph 209, since it varies over time. Further, since an IMT value is to be synchronized with a biosignal, graph 210 of a biosignal is displayed parallel to the graph of the IMT, and bar 211 is displayed at the phase which is presently measured (step 111: display of measurement result).
Next, the examinee performs fine adjustment of boundary positions using the input unit 15. There are cases that the process for correcting noise is not sufficient enough for correction of the extracted boundaries. At this time, the examiner manually or semi-automatically performs fine adjustment on the boundary positions while observing the boundaries displayed in step 111. The manual adjustment is performed using the input unit 15. For example, fine adjustment is performed by dragging and dropping a part of the boundary. The semi-automatic adjustment is performed by changing the processing parameter related to the boundary such as the coordinates of the boundary, the threshold value for region segmentation, the threshold value for boundary correction and the boundary extraction range (step 112: fine adjustment of boundary).
Next, the control unit 16 determines whether the measurement is completed or not (step 113). In the case that the measurement is to be continued, after waiting for the measurement timing set in step 102, step 103˜step 112 are repeatedly executed (step 113: determination of measurement completion).
In accordance with the present embodiment, it is possible to restrain the influence of noise in boundary extraction for IMT measurement.
Also, the characteristic effect in the present embodiment is that the boundaries which are interconnected in the longitudinal direction of a blood vessel can be extracted without discontinuity since parting lines are initially extracted. Further, the boundary extracting range can be limited on the basis of parting positions, thus restriction of noise can be performed without being influenced by the noise which is far from the boundary. Even when influenced by noise, correction can be made by the boundary correction process. Also, by semi-automatic boundary adjustment which changes the boundary processing parameter, the examiner can adjust the boundary as desired.
In the second embodiment, region segmentation is executed by binarization, not by three-valued processing. The apparatus configuration in
The control unit 16 causes the region segmentation unit 10 to segment an ROI into two regions of a lumen side region and an outer-membrane side region using the image brightness value within the ROI. Extraction of parting lines will be described using
Also, outer-membrane side region Reg3 includes a part of the intima-media region and the outer-membrane region. Since the two regions have different brightness respectively, the region is segmented into two by providing threshold value Th13 to the brightness value. Threshold value Th13 should be provided at the position of the apex of local maximum value Pe2. The region can be segmented into two regions by executing binarization using threshold value Th13. As for the threshold determination method, the method such as extracting the local maximum value of the center part in the diagram, the percentile method or the discriminant analysis method can be applied. The result of region segmentation shown in
The control unit 16 causes the boundary correction unit 11 to correct the position of the parting line as shown in an example of
Next, the control unit 16 causes the boundary extraction unit 12 to extract lumen side boundary B5 and outer-membrane side boundary B6 of an intima-media region.
In accordance with the present embodiment, it is possible to restrain the influence of noise in boundary extraction for IMT measurement.
The characteristic effect of the present embodiment is that calculation amount for region segmentation and correction of parting lines can be reduced since only one threshold value needs to be calculated while two threshold values are necessary in the first embodiment.
The third embodiment enables re-setting of a threshold value by freezing an image (a 3-valued image in the first embodiment, and a binarized image in the second embodiment). Also, the third embodiment is another modified example of step 108.
The thick lines in
In accordance with the present embodiment, it is possible to restrain the influence of noise in boundary extraction for IMT measurement.
Also, characteristic effect of the present embodiment is that boundary extraction at a position with higher accuracy can be executed, since boundary extraction stating positions can be set while avoiding boundary positions, thereby preventing deviance of extraction.
In the first˜third embodiments, the direction for boundary extraction is set parallel to the right and the left sides (narrow sides) of a rectangle which is set as an ROI. The method in the present embodiment sets the direction for boundary extraction in accordance with the running direction of a carotid artery or the direction of a probe. Step 104 and step 108 of which the processing content is different from the first embodiment will be described.
The examiner sets an ROI at a target position for IMT measurement on carotid artery image 202 using the ROI setting unit 8. The difference from the first embodiment is to modify the shape of an ROI. The examiner adjusts the shape of an ROI using the input unit 15. Then the examiner sets the extracting direction in accordance with the shape of ROI or the running direction of a carotid artery in step 108.
The present invention can be applied to an ultrasonic wave signal outputted from the ultrasonic signal generation unit 5, and also to a carotid artery anterior wall which is diphycercal to the carotid artery exterior wall simply by reversing the extracting direction.
In accordance with the present embodiment, it is possible to restrain the influence of noise in boundary extraction for IMT measurement.
Also, characteristic effect of the present embodiment is that boundary extraction at more accurate position can be executed since an ROI can be set as more fitting and sufficient shape in accordance with the running direction of a carotid artery or the direction of a probe.
The preferable embodiments of the ultrasonic diagnostic apparatus, etc. according to the present invention have been described. However, the present invention is not limited to these embodiments. It is obvious that persons skilled in the art can make various kinds of alterations or modifications within the scope of the technical idea disclosed in this application, and it is understandable that they belong to the technical scope of the present invention.
1: ultrasonic diagnostic apparatus, 2: object, 3: ultrasonic probe, 4: ultrasonic signal transmission/reception unit, 5: ultrasonic signal generation unit, 6: ultrasonic image generation unit, 7: biosignal extraction unit, 8: ROI setting unit, 9: denoising unit, 10: region segmentation unit, 11: boundary correction unit, 12: boundary extraction unit, 13: IMT calculation unit, 14: output unit, 15: input unit, 16: control unit
Number | Date | Country | Kind |
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2009-139319 | Jun 2009 | JP | national |
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/JP2010/059503 | 6/4/2010 | WO | 00 | 12/8/2011 |