JP2000217809A - Fluoroscopic apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To reduce X-ray exposure and to reduce the trouble of setting conditions by correcting the radioscopic direction corresponding photographing X-ray condition according to a difference between the preset radioscopic X-ray condition and the reference radioscopic X-ray condition, and photographing under the corrected conditions. SOLUTION: Information on a photographing region and body thickness of a patient and a film is input from a console panel (S121). Subsequently, a catheter is passed from the thigh to select a blood vessel while looting at a radioscopic image (S122). The radioscopic conditionin the reference radioscopic direction is set by an automatic exposure control mechanism to obtain a difference from the reference radioscopic condition corresponding to the reference radioscopic direction stored in a radioscopic condition table. According to the difference, the radioscopic condition of the radioscopic condition table is corrected (S123) and photographing is performed (S124). Subsequently, the position of a support device is moved (S125), a set parameter and a photographing condition set table are compared to set required alteration (S126), and photographing is performed (S127). Thus, the exposure X-ray quantity is reduced and the trouble of setting conditions can be reduced.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an X-ray fluoroscopic apparatus having a function of automatically setting fluoroscopic X-ray conditions, and more particularly to a fluoroscopic apparatus for supporting an X-ray tube and an X-ray image receiving apparatus. The present invention relates to an X-ray fluoroscopic apparatus that automatically sets a radiographic X-ray condition corresponding to an imaging angle.

[0002]

2. Description of the Related Art In recent years, interventional radiology (hereinafter referred to as "IVR") treatments using catheters have been actively performed. This is because, for example, when there is an infarction in the coronary artery and a catheter is to be treated, a catheter is inserted from the femoral artery or the like, the catheter is advanced to the target blood vessel under X-ray fluoroscopy, and a balloon is placed at the target site. The stenosis is enlarged using a catheter, an atherectomy catheter, or the like.

[0003] In such an IVR procedure, a conventional circulatory organ X-ray inspection apparatus or a general fluoroscopy apparatus is used to perform X-ray imaging.
Since it is necessary to find a target blood vessel under fluoroscopy and quickly insert a catheter into the target blood vessel, it is necessary to position an imaging system, a support mechanism, a patient table, etc. at an optimal position under the fluoroscopy. There is. Such an operation was a conventional contrast examination, but became more necessary due to the IVR procedure.

That is, a target treatment site is determined from an X-ray fluoroscopic image obtained at the time of diagnosis, and a guide for moving the catheter in a blood vessel to reach the target treatment site when performing treatment by IVR. As X
Fluoroscopy becomes even more important. Therefore, the catheter is brought close to the region of interest, and the center of the field of view of the cine camera is brought to the site to be viewed, or the position is slightly shifted to perform a fine positioning operation.

[0005] As described above, the IVR and the contrast examination are performed, for example, when a diseased part is present in the head, by inserting a catheter from the femoral artery and observing the progress of the catheter by X-ray fluoroscopy to observe an X-ray image. I will proceed with checking on the monitor. In particular, in the head, heart, and abdomen, it is difficult to understand a complicated state of blood vessel traveling only by one-way fluoroscopy in order to selectively advance blood vessels through which the catheter is advanced. Therefore, the fluoroscopic direction is changed, the running of the blood vessel is confirmed from various directions, and the treatment is advanced.

On the other hand, a table on which a patient is placed can perform a floating operation in which the patient can move in various directions including the body axis direction, and can also change the height direction.

[0007] As described above, the image system supporting apparatus (hereinafter, referred to as a support) which supports the X-ray tube apparatus and the X-ray image receiving apparatus and the patient table select a target blood vessel from complicated blood vessels. It is configured to be able to cope with fluoroscopy and imaging positioning from other directions. Using these functions, the supporter and the patient table are positioned, X-rays are emitted from an X-ray tube, and the X-rays transmitted through the patient are converted into an image intensifier (hereinafter referred to as II).
This is converted into an optical image, further converted into an electric signal, and subjected to image processing by an image processing device to form an X-ray fluoroscopic image. In this case, the field size of the X-ray transmission image detected in the above II is selected, and appropriate fluoroscopy,
The photographing area can be determined.

These operations are repeated to position the patient table and the support, perform X-ray fluoroscopy while determining the size of the field of view II, advance the catheter, and reach the target position. X-ray imaging is performed by setting an imaging X-ray condition (hereinafter, referred to as an imaging condition) corresponding to the line condition (hereinafter, referred to as a fluoroscopic condition). By repeating the above operations, the surgeon proceeds with the procedure, and performs examination and treatment.

In the above-described IVR procedure performed in the prior art, X-ray fluoroscopy and radiographing are frequently performed by changing the angle of the support and the size of the visual field of II. The fluoroscopic and radiographic conditions at this time are shown in FIG. It is set automatically by the mechanism shown.
This method is described below.

(1) First, X-rays transmitted through the patient
Then, the value of the output light amount of the above II corresponding to the transmitted X-ray dose is set. This is defined as a specified light amount. (2) Step 101 The angle of the support and the size of the field of view of II are set. (3) Step 102 X-rays are emitted under predetermined fluoroscopic conditions, that is, tube voltage and tube current, and fluoroscopy is performed. The X-ray dose to be output based on the tube voltage and the tube current is determined. (4) Step 103 The X-ray output from the X-ray tube passes through the patient. (5) At step 104II, the X-ray dose transmitted through the patient is captured, and the
A dose is detected. (6) Convert the X-ray dose detected in step 105II into a light quantity. (7) Step 106 The value is compared with the value of the specified light amount set first. (8) Step 107

At this time, if the amount of light corresponding to the amount of X-rays transmitted through the patient does not match the specified amount of light, the tube voltage and tube current are adjusted so that the amount of light becomes the specified amount of light (see FIG. Tube voltage,
Tube current is adjusted), and the value is fed back to step 102. This adjustment is repeated until the light amount corresponding to the X-ray amount transmitted through the patient coincides with the set prescribed light amount.

(9) Step 108 As a result of the above adjustment, if the light amount corresponding to the X-ray dose transmitted through the patient matches the set prescribed light amount, the photographing conditions (tube voltage, (Tube current, imaging time, etc.) are set and stored. (This is to read out the imaging conditions corresponding to the perspective conditions from the imaging condition tables corresponding to the respective perspective conditions stored in advance, and to set the imaging conditions.) (10) Step 109 Perform X-ray photography.

[0013]

In the above-mentioned IVR procedure, the position of the support, the irradiation angle of X-rays from the X-ray tube supported by the support, and the size of the field of view of II are changed.
Fluoroscopy and imaging are frequently performed. At this time, if the position and angle of the support are changed, the body thickness of the patient also changes. Therefore, it is necessary to change the fluoroscopic conditions and imaging conditions accordingly.

In the conventional method, X-ray fluoroscopy is performed at the changed position and angle of the support, the tube voltage, the tube current, etc. are adjusted to set the fluoroscopy conditions. Had to take a way.

However, in the above-mentioned conventional method, every time the position and angle of the supporter and the size of the field of view II are changed, X is changed.
The fluoroscopy must be performed, and the amount of X-ray exposure to the patient and the operator has increased by the amount of the fluoroscopy.

Further, since the X-ray fluoroscopy must be performed after changing the position and angle of the support and the size of the field of view II, much time and effort are required for that.

Accordingly, an object of the present invention is to solve the above-mentioned problems, to reduce the amount of X-ray exposure to patients and operators, and to reduce the time and effort for setting fluoroscopy and imaging conditions. It is to provide a photographing device.

[0018]

SUMMARY OF THE INVENTION It is an object of the present invention to provide a table on which a subject is placed, an X-ray tube arranged to face each other across the table, and an X-ray image transmitted through the subject into an optical image. An X-ray condition setting unit for setting X-ray fluoroscopic conditions of the subject, and an imaging X-ray condition storage unit for storing X-ray imaging conditions corresponding to the X-ray fluoroscopic conditions. An X-ray imaging condition corresponding to the fluoroscopic X-ray condition set by the X-ray fluoroscopic condition setting means is read out from the X-ray imaging condition storage means to set an X-ray imaging condition, and imaging is performed using the set X-ray imaging condition. In the X-ray fluoroscopic apparatus, a fluoroscopic X corresponding to a fluoroscopic direction serving as a reference of the subject is provided.
Reference fluoroscopic X-ray condition storing means for storing line conditions, and fluoroscopic direction corresponding radiographic X-ray condition storing means for storing radiographic X-ray conditions corresponding to various fluoroscopic directions including the fluoroscopic direction as a reference of the subject, Positioning the X-ray tube and the image receiving apparatus in a fluoroscopic direction based on the fluoroscopic direction of the subject,
A fluoroscopic X-ray condition is set by a line condition setting means, and the fluoroscopic direction corresponding imaging is performed according to a difference between the set fluoroscopic X-ray condition and a reference fluoroscopic X-ray condition stored in the reference fluoroscopic X-ray condition storage means. X-ray condition correction means for correcting the X-ray conditions corresponding to the fluoroscopic direction stored in the X-ray condition storage means. This is achieved by shooting using

[0019]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS FIG. 3 is an overall configuration diagram when the present invention is used in a circulatory organ X-ray inspection apparatus. In FIG.
Is a patient (subject), 2 is a table on which the patient is placed, 3 is a monitor for observing an X-ray fluoroscopic image or an X-ray photographed image, 4 is a support for supporting the II 5 and the X-ray tube 6, 7 Is an operating device in which switches for operating the above-mentioned support device, table and the like are arranged, and these are arranged in an examination room. On the other hand, in the operation room, there is an operation console 8 and the like for remote control of a support, a table and the like, and setting of various photographing conditions and the like.

The operation of each element in this device will be described. This apparatus is mainly used for a contrast examination of a head, a heart, an abdomen and the like.

[0021] Contrast inspection is, for example, for inserting a catheter through a femoral vein of a patient when there is a diseased part in the head and observing the progress of the catheter by X-ray fluoroscopy to observe an X-ray image. We proceed while checking on the monitor. In particular, in order to selectively advance a blood vessel into which a catheter is to be inserted in the head or heart, it is difficult to understand a complicated blood vessel running state only by one-way fluoroscopy.

Therefore, II5 supported by the support 4
Then, the fluoroscopic direction is changed by the X-ray tube 6, and the running state of the catheter in the blood vessel is confirmed by viewing from another angle. On the other hand, the table 2 can perform a floating operation that can be moved in various directions including the body axis direction of the patient, and can change the height direction. In this way, it is possible to perform fluoroscopy and positioning of the imaging system from other directions, and select a target blood vessel from complicated blood vessels. The X-ray exposure during fluoroscopy is performed by the foot switch 9.
Performed by This apparatus is obtained by applying the fluoroscopy and imaging condition setting method of the present invention to the voice operation method disclosed in JP-A-8-229028, and includes a voice input device 10, a voice recognition device 11, and an integrated control unit 12. And an operation command transmitting device 15 and a control unit 20 of each device.

The device to be operated and words (operation commands) corresponding to the operation settings of the device are registered in advance by the voice of the operator 30 who operates the device, and are stored in the voice recognition device 11. When the surgeon 30 inputs the words into the microphone of the voice input device 10 during operation of the device, the voice recognition device 11 recognizes and decodes the words and sends the words to the voice input operation control unit 13 of the integrated control unit 12. introduce. The voice input operation control unit 13 analyzes the operation contents of each device corresponding to the word and refers to the photographing condition setting data stored in the photographing condition storage device 14 from the photographing conditions of the previous operation contents. Then, a shooting condition corresponding to the content of the current operation is obtained.

The photographing conditions corresponding to the contents of the current operation are set, and the analyzed contents of the current operation are transmitted to the operation command transmitting device 15 to set the operation of each device. An operation is performed by inputting the information to the unit 20.

Next, the details of the main part of the present invention will be described. First, an imaging X-ray condition table as shown in FIG. 2 is created in advance based on data obtained by past X-ray imaging and inspection. This shows parameters necessary for determining X-ray imaging conditions, and values such as an exposure amount, a tube voltage, and a tube current set according to the state of the parameters. Parameters include the patient's site and body thickness,
And the type of film for obtaining the image, the angle of the support, the size of II, and the like. There is no limitation on this parameter, and it may be provided as needed.

FIG. 1 shows an example of a procedure for automatically setting photographing conditions according to the present invention, taking a case where a patient's head is subjected to a contrast test. (1) Step 121 First, before the examination, the operator inputs information (parameters) such as the imaged part of the patient, the body thickness, and the film to setting means (not shown) on the console 8. As an example, here, the imaging part is input as “head”, the body thickness is “thin”, and the film is “intensifying screen”. The angle of the support at this time is angle 1 (LA
O; Left Anterior Oblique, RAO; Right Anterior
Oblique) and angle 2 (CRA; Clanial, CAU; Caudal) are both PA (front to patient's body) (the fluoroscopic direction at this time is the standard fluoroscopic direction), and the II size is 9 inches.

(2) Step 122 The operator selectively advances the blood vessel while seeing the X-ray fluoroscopic image through the catheter from the thigh and the like by X-ray fluoroscopy.

(3) Step 123 At the time of this X-ray fluoroscopy, the above-mentioned "automatic exposure control mechanism" adjusts the tube voltage, tube current, and the like to obtain a necessary exposure amount, and performs fluoroscopy in the reference fluoroscopic direction. Set conditions. In this case, when the fluoroscopic X-ray condition matches the fluoroscopic X-ray condition for the predetermined reference fluoroscopic direction or is within a certain range, the radiographing condition corresponding to the fluoroscopic X-ray condition is stored in the radiographing X-ray condition table. Select from and set. The imaging X-ray condition table is a table that stores imaging X-ray conditions corresponding to various fluoroscopic directions including a fluoroscopic direction that is a reference of the subject, and is a fluoroscopic direction that is based on the fluoroscopic direction of the subject. Then, the X-ray tube and the image receiving device are positioned, and the fluoroscopic X-ray condition setting means (specifically, the automatic exposure control mechanism) sets fluoroscopic X-ray conditions. The radiographing X-ray conditions in the radiographing X-ray condition table are corrected in accordance with the difference from the fluoroscopic X-ray conditions corresponding to the reference fluoroscopic direction stored in the X-ray condition table, and the corrected radiographing X-ray conditions are used. It is used for shooting. This correction is
The correction amount may be stored in the imaging X-ray condition table, and the correction amount may be obtained by adding or subtracting the correction amount from the value in the imaging X-ray condition table. Alternatively, the imaging X-ray condition including the correction amount may be calculated. Stored in the imaging X-ray condition table,
The correction may be made with reference to this.

(4) Step 124 X-ray imaging is performed under the set imaging X-ray conditions. (5) Step 125 Next, in order to photograph the head from the left side with respect to the patient's body, the support is moved to a position of "LAO 90 degrees" to perform positioning. In this case, the support angle 1 is LAO 90 degrees, and the support angle 2 remains PA. I at this time.
The size of I. shall remain 9 inches.

(6) Step 126 As the position of the supporter is changed in (5), the set parameters are compared with the shooting condition setting table, and the shooting conditions when the parameters match, ie, the tube voltage, Change and set tube current, etc.

(7) Step 127 The photographing can be performed at the position on the left side surface according to the photographing conditions set in (6). Further, after this, even when the angle of the supporter or the size of the field of view of II is changed, the photographing conditions are automatically set by using the photographing condition setting table.

According to the above-described method, appropriate photographing conditions can be automatically set without performing fluoroscopy even if the angle of the supporter or the size of the field of view II is changed. Further, in the present invention, the list of the imaging condition setting tables can be displayed to the operator, and the imaging conditions can be changed or added. As described above, when the angle of the support or the field size of II is changed, it is not necessary to perform the fluoroscopy for setting the imaging conditions.

[0033]

As described above, in the system using the present invention, even if the angle of the supporter or the size of the field of view of II is changed, it is not necessary to perform the fluoroscopy for setting the photographing conditions in this case. X-ray exposure to patients and operators is reduced.

[Brief description of the drawings]

FIG. 1 is a flowchart for automatically setting photographing conditions according to the present invention.

FIG. 2 is an example of a photographing condition setting table according to the present invention.

FIG. 3 is an overall configuration diagram of a circulatory organ X-ray inspection apparatus using the method for automatically setting imaging conditions according to the present invention.

FIG. 4 is a flowchart of a conventional automatic setting of photographing conditions.

[Explanation of symbols]

 REFERENCE SIGNS LIST 1 subject (patient) 2 subject table 3 image display monitor 4 ceiling-suspended C-arm support 5 X-ray tube 6 image intense fire (II) 7 operating device 8 operation console 9 foot switch 10 voice input device 11 voice recognition Device 12 Integrated control unit 13 Voice input operation control device 14 Imaging condition storage device 15 Operation command control device 20 Control unit of each device

Claims (1)

[Claims] 1. A table on which a subject is placed, an X-ray tube arranged to face each other across the table, an image receiving device for converting an X-ray image transmitted through the subject into an optical image, and the subject A fluoroscopic X-ray condition setting means for setting fluoroscopic X-ray conditions; and a radiographic X-ray condition storing means for storing radiographic X-ray conditions corresponding to the fluoroscopic X-ray conditions, wherein the fluoroscopic X-ray condition setting means The imaging X-ray conditions corresponding to the fluoroscopic X-ray conditions set in the above are read out from the imaging X-ray condition storage means,
A reference fluoroscopic X-ray condition storage unit configured to store a fluoroscopic X-ray condition corresponding to a reference fluoroscopic direction of the subject in an X-ray fluoroscopic apparatus configured to set a line condition and perform imaging under the set radiographic X-ray condition; A fluoroscopic direction-corresponding radiographic X-ray condition storage means for storing radiographic X-ray conditions corresponding to various fluoroscopic directions including the fluoroscopic direction as a reference of the subject, and a radiographic direction corresponding to the fluoroscopic direction of the subject. The X-ray tube and the image receiving apparatus are positioned, and the fluoroscopic X-ray condition setting means sets fluoroscopic X-ray conditions. The set fluoroscopic X-ray condition and the reference fluoroscopic X-ray are set.
The perspective direction corresponding radiography X for correcting the perspective direction corresponding radiographic X-ray condition stored in the perspective direction corresponding radiographic X-ray condition storage means in accordance with a difference from the reference fluoroscopic X-ray condition stored in the line condition storage means. An X-ray fluoroscopic apparatus, comprising: a line condition correcting unit; and performing imaging using the imaging X-ray conditions corrected by the fluoroscopic direction corresponding imaging X-ray condition correcting unit.