The present application claims priority based on Japanese Patent Application No. 2021-171749, filed Oct. 20, 2021, the content of which is incorporated herein by reference.
Embodiments disclosed in the present description and drawings relate to an ultrasonic diagnostic apparatus, an information-processing method, and a storage medium.
To obtain information on a cross section, three-dimensional tissue structure, or physical properties of a diagnostic part of a living body, an ultrasonic diagnostic apparatus that images information in the living body by transmitting ultrasonic beams, receiving reflected waves from tissue boundaries within a subject having different acoustic impedances, and processing the received signal has been commercialized.
There are various types of ultrasonic probes serving as sensors for transmitting and receiving ultrasonic beams depending on diagnostic parts, such as ones applied to the surface of the body and ones that are inserted into body cavities. For example, there is a transesophageal echocardiography (TEE) probe having an ultrasonic transducer at the tip or the like in order to observe the state of the heart of a subject through the esophagus. This transesophageal echocardiography probe is used by being inserted into upper digestive organs of a subject, such as the esophagus and stomach. An ultrasonic diagnostic apparatus can acquire and display the state of the heart and the like using the transesophageal echocardiography probe inserted into the upper digestive organs.
For example, there is a transesophageal echocardiography probe having an array-shaped ultrasonic transducer disposed at the tip thereof and capable of manually rotating around the center of the ultrasonic transducer or automatically rotating by a motor or the like. This transesophageal echocardiography probe may further include a container filled with an ultrasound transmission medium.
The upper digestive organs such as the esophagus and stomach differ in size and shape depending on the living body. Therefore, it is required to efficiently insert the transesophageal echocardiography probe into the digestive organs or to bring the ultrasonic transducer surface into close contact with the inner wall surface with an appropriate pressure for the purpose of obtaining optimum in-vivo information, and the structure near the tip of the probe is bendable and needs to have flexibility for bending.
On the other hand, due to this flexibility, the transesophageal echocardiography probe may be bent when inserted into the esophagus which has various shapes depending on the living body. Since the transesophageal echocardiography probe receives reflected ultrasonic waves to generate an ultrasonic image, the ultrasonic image may not be displayed while it is inserted into the esophagus. That is, even if the transesophageal echocardiography probe is bent in the esophagus, it is difficult for an operator to check this state. Despite the fact that the transesophageal echocardiography probe is bent in the esophagus in this manner, the operator cannot check the state of the transesophageal echocardiography probe, and thus there is a risk of damaging the inner wall of the esophagus by the tip of the transesophageal echocardiography probe being hooked on the esophagus when the operator intends to remove the transesophageal echocardiography probe in a bent state.
In addition, bending degree control for bringing the ultrasonic transducer surface into close contact with the inner wall surface with an appropriate pressure is performed according to an operator's experience depending on an image displayed on an ultrasonic diagnostic apparatus and a subtle sense of resistance of the transesophageal echocardiography probe at hand, and thus an objective and appropriate amount of bending cannot be ascertained, which causes a burden on the inner wall due to the probe being pressed against the inner wall with more pressure than necessary, or an ultrasonic image with a sufficient signal-to-noise (S/N) ratio cannot be acquired due to pressing with insufficient bending, which may reduce diagnostic efficiency.
Furthermore, the above-mentioned problems such as the risk of damage to the body cavity and a decrease in diagnostic efficiency are not limited to the transesophageal echocardiography probe and are generally common to ultrasonic probes inserted into the body cavity, such as transvaginal ultrasonic probes and transrectal ultrasonic probes.
An ultrasonic diagnostic apparatus, an information-processing method, and a storage medium according to embodiments will be described below with reference to the drawings. An ultrasonic diagnostic apparatus of an embodiment includes a processing circuitry. The a processing circuitry acquires contact information detected by a plurality of contact sensors provided at different positions on an ultrasonic probe inserted into a body cavity of a subject and causes an output interface to output information representing a state of the ultrasonic probe in the body cavity on the basis of the contact information and the positions of the contact sensors provided on the ultrasonic probe.
The ultrasonic probe 110 is operated by a user such as a doctor or a nurse and generally includes a type that contacts the body surface of a subject and a type that is inserted into the body cavity. In the present embodiment, a probe of the type that is inserted into the body cavity will be described below. The ultrasonic probe 110 may be a transesophageal echocardiography probe, or a transvaginal or transrectal ultrasonic probe. For example, if the ultrasonic probe 110 is a transesophageal echocardiography probe, the ultrasonic probe 110 is inserted into upper digestive organs such as the esophagus and stomach. A subject is, for example, a human being, but is not limited thereto. The ultrasonic probe 110 transmits (radiates) ultrasonic waves to a subject, for example, in order to acquire an image inside the body cavity. The ultrasonic probe 110 receives echoes (reflected waves) of the transmitted ultrasonic waves. The ultrasonic probe 110 then generates signal data of the received echo (hereinafter referred to as echo data) and outputs the echo data to the ultrasonic diagnostic apparatus 100. For example, the ultrasonic probe 110 may be a probe in which a plurality of transducers for transmitting and receiving ultrasonic waves are one-dimensionally arranged and have a rotating mechanism, or a two-dimensional array probe in which a plurality of transducers are arranged in a two-dimensional array. In this case, the echo data may be, for example, three-dimensional volume data in which an echo signal intensity is associated with each unit area obtained by dividing a three-dimensional space having a width, a height, and a depth.
The insertion part 111 is a part that is inserted into the body cavity and has a tip portion 111a, a bending portion 111b, and a guide intermediate portion 111c. A transducer T for transmitting and receiving ultrasonic waves is attached to the tip portion 111a. The bending portion 111b is a portion of the insertion part 111 which has a bending structure. Due to the presence of the bending portion 111b, the insertion part 111 can be easily inserted into the body cavity, the transducer T can be brought into close contact with the inner wall surface of the body cavity with an appropriate pressure, or an ultrasonic beam can be transmitted to an organ that is a diagnosis target (for example, the heart) with high efficiency. The guide intermediate portion 111c is an intermediate portion of the insertion part 111 which does not have a bending structure. In a bending direction of the bending portion 111b, since the transducer T of the tip portion 111a is pressed against the inner wall in general, a side where the bending portion 111b bends and shrinks is referred to as a front side and a side where the bending portion 111b warps and stretches conversely is referred to as a back side for convenience of description.
A transducer rotation knob, a vertical bending knob, a lock lever, and the like which are can be operated by a user are attached to the operation part 112. The transducer rotation knob is an operator for rotating the insertion part 111 in the extending direction thereof. The vertical bending knob is an operator for bending the bending portion 111b toward the front side or stretching it toward the back side. The lock lever is an operator for fixing the insertion part 111 moved by operating the transducer rotation knob or the vertical bending knob at that position.
The operation part 112 includes an actuator (for example, an electric motor or the like) that rotates, bends, or stretches the insertion part 111 without depending on a user operation performed on operators such as the transducer rotation knob and the vertical bending knob.
The probe cable 113 is a cable that electrically connects the insertion part 111 and the operation part 112 with the connector part 114.
The connector part 114 is an input/output interface electrically connected to the ultrasonic diagnostic apparatus 100 or a terminal thereof.
As shown in
A description of the configuration diagram of the ultrasonic diagnostic apparatus 100 in
In the present description, the input interface 120 is not limited to one including physical operation components such as a mouse and a keyboard. For example, examples of the input interface 120 also include an electrical signal processing circuitry that receives an electrical signal corresponding to an input operation from an external input device provided separately from the apparatus and outputs the electrical signal to a control circuit.
The output interface 130 includes, for example, the display 130a and a speaker 130b. The display 130a displays various types of information. For example, the display 130a displays information output by the processing circuitry 150 as an image or displays a graphical user interface (GUI) for receiving various input operations from the user. For example, the display 130a is a liquid crystal display (LCD), an organic electroluminescence (EL) display, or the like. The speaker 130b outputs information output by the processing circuitry 150 as sound. The output interface 130 is an example of an “output unit.”
The communication interface 140 includes, for example, a network interface card (NIC) and an antenna for wireless communication. The communication interface 140 communicates with the ultrasonic probe 110 connected via the connector part 114 and communicates with an external device via a communication network NW.
The communication network NW may be any information communication network using telecommunication technology. For example, the communication network NW includes a local area network (LAN), a wide area network (WAN), the Internet, a telephone communication network, an optical fiber communication network, a cable communication network, a satellite communication network, or the like.
The external device may be, for example, a computer connected to a hospital backbone LAN. That is, the external device may be a computer in a medical institution where the ultrasonic diagnostic apparatus 100 is installed. Such a computer is also called a workstation. Further, the external device may be a cloud server or the like connected to a WAN or the Internet.
When the ultrasonic probe 110 is a wireless probe, the communication interface 140 may communicate with the ultrasonic probe 110 wirelessly such as through Wi-Fi.
The processing circuitry 150 includes, for example, an acquisition function 151, a bending degree estimation function 152, a risk estimation function 153, an image generation function 154, a probe control function 155, and an output control function 156. The processing circuitry 150 realizes these functions by a hardware processor (computer) executing a program stored in the memory 160 (storage circuit), for example. The acquisition function 151 is an example of an “acquisition unit” and a combination of the bending degree estimation function 152 and the risk estimation function 153 is an example of an “estimation unit,” a “generation unit,” or a “determination unit.” The probe control function 155 is an example of a “probe control unit” and the output control function 156 is an example of an “output control unit.”
The hardware processor in the processing circuitry 150 refers to, for example, a circuit (circuitry) such as a central processing unit (CPU), a graphics processing unit (GPU), an application specific integrated circuit (ASIC), or a programmable logic device (for example, a simple programmable logic device (SPLD), a complex programmable logic device (CPLD), or a field programmable gate array (FPGA)). Instead of the program being stored in the memory 160, the program may be directly incorporated into the circuit of the hardware processor. In this case, the hardware processor realizes functions by reading and executing the program incorporated in the circuit. The aforementioned program may be stored in the memory 160 in advance, or may be stored in a non-transitory storage medium such as a DVD or a CD-ROM and installed in the memory 160 from the non-transitory storage medium by setting the non-transitory storage medium in a drive device (not shown) of the ultrasonic diagnostic apparatus 100. The hardware processor is not limited to being configured as a single circuit and may be configured as one hardware processor by combining a plurality of independent circuits to realize each function. Further, a plurality of components may be integrated into one hardware processor to realize each function.
For example, the acquisition function 151 acquires echo data from the ultrasonic probe 110 and acquires pressure information from each pressure sensor provided on the ultrasonic probe 110 via the communication interface 140.
The bending degree estimation function 152 estimates a bending state of the ultrasonic probe 110 on the basis of the pressure information acquired from each pressure sensor by the acquisition function 151 and the installation position of each pressure sensor.
The risk estimation function 153 estimates a degree of risk that the ultrasonic probe 110 will damage the inner wall of the body cavity on the basis of at least the pressure information between the pressure information acquired from each pressure sensor by the acquisition function 151 and the bending state of the ultrasonic probe 110 estimated by the bending degree estimation function 152, or both the pressure information and the bending state.
Further, the risk estimation function 153 may estimate or determine whether or not the surface of the transducer T (ultrasonic radiation surface) is in contact with the inner wall of the body cavity with a predetermined pressure on the basis of the pressure information.
The image generation function 154 generates an ultrasonic image of the inside of the body cavity on the basis of the echo data acquired by the acquisition function 151.
The probe control function 155 controls the bending degree of the ultrasonic probe 110 on the basis of the bending state of the ultrasonic probe 110 estimated by the bending degree estimation function 152.
The output control function 156 outputs the pressure information acquired from each pressure sensor by the acquisition function 151 via the output interface 130. The output control function 156 may also output the bending state estimated by the bending degree estimation function 152 via the output interface 130. In addition, the output control function 156 may output the degree of risk estimated by the risk estimation function 153 or a result of determination of whether or not the transducer T is in contact with the inner wall of the body cavity with a predetermined pressure via the output interface 130. The bending state, the degree of risk, and the like are examples of “information based on a bending state.”
The memory 160 is realized by, for example, a random access memory (RAM), a semiconductor memory device such as a flash memory, a hard disk, or an optical disc. These non-transitory storage media may be realized by other storage devices such as a network attached storage (NAS) and external storage server devices connected via the communication network NW. Further, the memory 160 may also include non-transitory storage media such as a read only memory (ROM) and registers.
Processing of each function performed by the processing circuitry 150 of the ultrasonic diagnostic apparatus 100 according to the first embodiment will be described below with reference to a flowchart.
First, the acquisition function 151 acquires pressure information from each pressure sensor of the ultrasonic probe 110 in accordance with a predetermined cycle (step S100).
Next, the risk estimation function 153 generates a bull's eye map on the basis of the pressure information acquired from each pressure sensor by the acquisition function 151 and the installation position of each pressure sensor (step S102). A bull's eye map is a pressure distribution in which pressure values indicated by pressure information of respective pressure sensors are arranged and displayed on one concentric circle. A bull's eye map is an example of a “contact information map.”
Specifically, the pressure value of the pressure sensor A2, the pressure value of the pressure sensor A4, the pressure value of the pressure sensor A6, and the pressure value of the pressure sensor A8 are arranged and displayed in order from the center to the outside in the first quadrant of the bull's eye map. The pressure value of the pressure sensor A1, the pressure value of the pressure sensor A3, the pressure value of the pressure sensor A5, and the pressure value of the pressure sensor A7 are arranged and displayed in order from the center to the outside in the second quadrant of the bull's eye map. The pressure value of the pressure sensor B1, the pressure value of the pressure sensor B3, the pressure value of the pressure sensor B5, and the pressure value of the pressure sensor B7 are arranged and displayed in order from the center to the outside in the third quadrant of the bull's eye map. The pressure value of the pressure sensor B2, the pressure value of the pressure sensor B4, the pressure value of the pressure sensor B6, and the pressure value of the pressure sensor B8 are arranged and displayed in order from the center to the outside in the fourth quadrant of the bull's eye map. The bull's eye map may be represented by a heat map in which each pressure value is replaced with a pixel value such as a grayscale, luminance, or saturation. The following description is based on the assumption that a dark-colored portion (dark portion, close to black) corresponds to a low pressure and a light-colored portion (bright portion, close to white) corresponds to a high pressure on a bull's eye map.
A description of the flowchart of
Note that the risk estimation function 153 may estimate a degree of risk that the ultrasonic probe 110 will damage the inner wall of the body cavity on the basis of the bending degree estimated by the bending degree estimation function 152 in addition to the pressure values of the bull's eye map.
Further, the risk estimation function 153 may estimate a degree of risk from one image called a bull's eye map using machine learning.
A description of the flowchart of
In addition, as shown in
A description of the flowchart of
For example, when the bending degree estimation function 152 estimates that the insertion part 111 of the ultrasonic probe 110 has been bent, the probe control function 155 may stretch the insertion part 111 by controlling the actuator of the operation part 112 via the connector part 114. Further, when the bending portion 111b is bent and the tip portion 111a of the insertion part 111 is in strong contact with the inner wall of the body cavity as shown in
Processing of this flowchart ends with such a series of processing. As described above, the processing of this flowchart is repeatedly executed at a predetermined cycle. That is, when pressure information is repeatedly acquired from each pressure sensor by the acquisition function 151 at a predetermined cycle, the risk estimation function 153 repeats generation of a bull's eye map on the basis of the repeatedly acquired pressure information each time pressure information is repeatedly acquired by the acquisition function 151. The bending degree estimation function 152 repeats estimation of a bending state of the ultrasonic probe 110 on the basis of repeatedly generated bull's eye maps each time a bull's eye map is repeatedly generated. Similarly, the risk estimation function 153 repeats estimation of a degree of risk on the basis of repeatedly generated bull's eye maps each time a bull's eye map is repeatedly generated. Then, the output control function 156 repeats output of information such as pressure information, a bending state, and a degree of risk.
According to the first embodiment described above, the acquisition function 151 acquires pressure information from each of the plurality of pressure sensors provided on the insertion part 111 of the ultrasonic probe 110. The risk estimation function 153 generates a bull's eye map, which is a pressure distribution diagram, on the basis of the pressure information of each pressure sensor acquired by the acquisition function 151 and the installation position of each pressure sensor. The bending degree estimation function 152 estimates a bending state of the ultrasonic probe 110 on the basis of the bull's eye map. The output control function 156 causes the output interface 130 to output information such as the pressure information, the bending state, and a degree of risk (that is, information representing a state of the ultrasonic probe 110). As a result, safety and diagnostic efficiency can be improved.
For example, when the bending state of the ultrasonic probe 110 is displayed on the display 130a, the operator of the ultrasonic probe 110 can check whether the ultrasonic probe 110 has been bent or not. As a result, it is possible to reduce the risk of the tip of the ultrasonic probe 110 being caught on the inner wall of the body cavity and damaging the subject when the operator intends to remove the ultrasonic probe 110 in a bent state from the body cavity. That is, the bending state of the ultrasonic probe 110 actually inserted into the body cavity can be estimated from the pressure information of each of the plurality of pressure sensors, and at the same time, it is possible to warn the operator that there is a possibility of damaging the wall surface of the body cavity due to removal or the like, and thus patient safety can be ensured.
In addition, since the operator can check a degree of bending of the ultrasonic probe 110 inserted into the body cavity, the transducer T can be appropriately brought into contact with a target part, thereby improving diagnostic efficiency.
Furthermore, as described above, the technology according to the present embodiment is generally applicable to ultrasonic probes that may be bent during diagnosis in addition to ultrasonic probes for transesophageal use. That is, the technology according to the present embodiment is not limited to transesophageal echocardiography probes and is applicable to general ultrasonic probes inserted into body cavities, such as transvaginal ultrasonic probes and transrectal ultrasonic probes.
Hereinafter, a second embodiment will be described. The second embodiment differs from the above-described first embodiment in that it is determined whether or not the transducer T is in contact with the inner wall of the body cavity with an optimum pressure. In the following, differences from the first embodiment will be mainly described, and description of common points with the first embodiment will be omitted. In the description of the second embodiment, the same parts as those of the first embodiment are denoted by the same reference numerals.
First, the acquisition function 151 acquires pressure information from each pressure sensor of the ultrasonic probe 110 in accordance with a predetermined cycle (step S200).
Next, the risk estimation function 153 generates a bull's eye map on the basis of the pressure information acquired from each pressure sensor by the acquisition function 151 and the installation position of each pressure sensor (step S202).
Next, the bending degree estimation function 152 determines whether or not the transducer T of the insertion part 111 is in contact with the inner wall of the body cavity with an optimum pressure on the basis of the bull's eye map (step S204).
For example, the bending degree estimation function 152 may determine that the transducer T is in contact with the inner wall of the body cavity with an optimum pressure if pressure values of the pressure sensors A1 to A4 provided on the same surface as the transducer T, that is, on the front surface side, among the pressure sensors A1 to A4 and B1 to B4 provided on the tip portion 111a, are within a predetermined numerical range (pressure range that can be regarded as optimum) on the bull's eye map, and may determine that the transducer T is not in contact with the inner wall of the body cavity with the optimum pressure if the pressure values of the pressure sensors A1 to A4 do not fall within the predetermined numerical range.
If it is determined that the transducer T is in contact with the inner wall of the body cavity with the optimum pressure, processing of this flowchart may end.
On the other hand, if it is determined that the transducer T is not in contact with the inner wall of the body cavity with the optimum pressure, the output control function 156 outputs information representing that the pressure required to bring the transducer T into contact with the inner wall of the body cavity is insufficient or information representing that the pressure is excessive via the output interface 130 (step S206).
Next, the probe control function 155 controls the bending degree of the ultrasonic probe 110 such that the pressure when the transducer T is brought into contact with the inner wall of the body cavity is optimized (step S208). Note that processing of S108 may be omitted.
According to the second embodiment described above, the bending degree estimation function 152 determines whether or not the transducer T is in contact with the inner wall of the body cavity with an optimum pressure on the basis of a bull's eye map. When it is determined that the transducer T is not in contact with the inner wall of the body cavity with an optimum pressure, the output control function 156 outputs information representing that the pressure is insufficient or excessive via the output interface 130, or the probe control function 155 controls the bending degree of the ultrasonic probe 110 such that the pressure is optimized. As a result, a high-quality ultrasonic image can be generated, and diagnostic efficiency can be further improved.
In general, controlling the bending degree of the ultrasonic probe 110 such that the transducer T is brought into close contact with the inner wall of the body cavity with an appropriate pressure is achieved by the operator checking an image displayed on the display 130a through experience or feeling a subtle resistance of the ultrasonic probe 110 at hand. Therefore, an objective and appropriate amount of bending cannot be ascertained to cause a burden on the inner wall by pressing the probe against the inner wall with more pressure than necessary, or an ultrasonic image with a sufficient signal-to-noise (S/N) ratio cannot be acquired due to pressing with insufficient bending, which may reduce diagnostic efficiency.
On the other hand, in the second embodiment, the operator is informed whether or not the transducer T is in contact with the inner wall of the body cavity with an optimum pressure, and the bending degree of the ultrasonic probe 110 is controlled such that the pressure is optimized (the transducer T is in contact with the inner wall more closely), and thus it is possible to improve diagnostic operation efficiency and enhance the throughput.
Hereinafter, other embodiments will be described. Although the processing circuitry 150 generates a bull's eye map, which is a pressure distribution diagram, on the basis of pressure information and the installation position of each pressure sensor, estimates a degree of bending of the ultrasonic probe 110, and additionally estimates a degree of risk of damaging the inner wall of the body cavity by the ultrasonic probe 110 in the above-described embodiment, the present invention is not limited thereto. For example, the processing circuitry 150 may estimate a degree of bending or a degree of risk of the ultrasonic probe 110 on the basis of the pressure information and installation position of each pressure sensor without generating a bull's eye map.
Although several embodiments have been described, these embodiments are presented as examples and are not intended to limit the scope of the invention. These embodiments can be implemented in various other embodiments, and various omissions, replacements, and changes can be made without departing from the gist of the invention. These embodiments and modifications thereof are included in the scope of the invention described in the claims and the equivalent scope thereof, as are included in the scope and gist of the invention.
Number | Date | Country | Kind |
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2021-171749 | Oct 2021 | JP | national |