Ultrasonic diagnostic apparatus

Abstract: Ultrasonic diagnostic apparatus, of the type having an ultrasonic probe (13) insertable into a body cavity of a patient under examination, for generating, when the apparatus is in use, an ultrasonic image of a selected part of that body cavity into which the probe (13) has been inserted, includes indicating means (17, 18, 19) for providing, in association with an ultrasonic image generated by the apparatus, an indication (20) of the posture held by the patient when the image was generated, preferably in addition to an indication (21) of which body cavity is shown in that image and/or an indication (23) of the point from, and direction in, which the image was taken, thereby facilitating accurate diagnosis.

Description: The present invention relates to ultrasonic diagnostic apparatus for displaying an ultrasonic image of a cavity within a patient by transmitting an ultrasonic wave toward a cavity wall and receiving an ultrasonic wave reflected by the cavity wall. Heretofore, ultrasonic diagnostic apparatus has been widely used for diagnosing diseases of various organs of human beings. In this case there are many modes of usage. In a typical mode, the ultrasonic diagnosis is carried out in a testing room while one or more doctors are watching a patient as well as ultrasonic images of the patient. There are many cases in which an operator takes photographs of ultrasonic images of a patient in the testing room and the photographs thus taken are checked or analyzed by a doctor in a room separate from the testing room. Further, due to developments in communication systems, a video signal representing the ultrasonic images of the patient picked-up in the testing room can be transmitted to the diagnosing room to display the ultrasonic images on a television monitor provided in the diagnosing room and the doctor performs the diagnosis by monitoring the ultrasonic images. There is a case that the video signal is recorded on a video tape by a video tape recorder, and after that ultrasonic images are reproduced on the monitor and the doctor can perform the diagnosis by watching the thus-reproduced ultrasonic images. In the typical usage of ultrasonic diagnostic apparatus, the doctor watches the patient whilst ultrasonic images are being obtained, and thus the doctor can know definitely what organ of the patient is being monitored from what direction, because the posture of the patient on a bed can be seen. However, when the doctor is not in the testing room whilst the images are being obtained, the doctor cannot always know accurately what organ of the patient is under inspection and in what posture the patient is lying on the bed during imaging, so that it is sometimes difficult to determine the condition of the patient in a correct manner. In order to avoid the above-mentioned inconvenience, in Japanese Patent Application Laid-open Publication JP-A-59-222140 published on December 13, 1984, there is proposed to display together with an ultrasonic image a body mark denoting an organ under test and a probe mark indicating a position of an ultrasonic probe on the patient body. As shown in Fig. 1 of the accompanying drawings, these body marks 1 and probe marks 2 are selected from a plurality of previously prepared figures which represent various combinations of the body marks and probe marks. In Japanese Patent Application laid-open Publication JP-A-60-72541 published on April 24, 1985, there is disclosed another known ultrasonic diagnostic apparatus in which a typical image of an organ is displayed in three-dimensional manner, a point at which the ultrasonic probe is positioned on the patient body is displayed by a line mark and a direction in which the ultrasonic wave is transmitted is denoted by a plurality of parallel arrows starting from the line. In Japanese Patent Application Laid-open Publication JP-A-63-317140 issued on December 26, 1988 a body mark is displayed on the monitor on which the ultrasonic image is displayed and a point under inspection is indicated by a special mark on the body mark. However, although the above-mentioned known ultrasonic diagnostic apparatus employing body marks, probe marks,organ patterns,line marks and arrows are useful to some extent for a case in which the ultrasonic probe is brought into contact with the outer surface of patient body, they are very inconvenient for a case in which the ultrasonic probe is inserted into a body cavity of the patient, because in the latter case it is rather difficult to know accurately what portion of an organ under test is being inspected and from what direction. Particularly, in the known ultrasonic diagnostic apparatus, the posture of the patient on the bed is not indicated, so that the direction in which the ultrasonic wave is transmitted cannot always be understood easily. Accordingly, it is desirable to provide a novel and useful ultrasonic diagnostic apparatus having an ultrasonic probe which is insertable into a cavity of a patient, in which it is possible to know easily and accurately what portion of an organ of the patient is under inspection, and thus facilitate the performance of a more accurate diagnosis with the aid of ultrasonic images displayed on a monitor. According to the present invention, there is provided ultrasonic diagnostic apparatus comprising: an ultrasonic probe which is insertable into a cavity of a patient and operable, when the apparatus is in use, to transmit an ultrasonic wave towards a wall of the said cavity and to generate an echo signal in dependence upon an ultrasonic wave reflected by the cavity wall; image signal processing circuitry connected to the said ultrasonic probe for receiving the said echo signal and processing the said echo signal to produce an ultrasonic image signal; memory means for storing a plurality of organ marks which represent various organs of the human body; selecting means for selecting a desired organ mark from amongst the said plurality of organ marks to produce an organ mark signal; image processing means for mixing the said organ mark signal representing the said desired organ mark with the said ultrasonic image signal generated by said image signal processing circuitry to produce a composite image signal; and displaying means for receiving said composite image signal and displaying on the basis thereof a composite image of the said ultrasonic image and organ mark; characterised in that the said memory means also store a plurality of posture marks which represent postures of a patient under examination, and in that the said selecting means are also operable to select a desired posture mark amongst the said plurality of posture marks to produce a posture mark signal, and in that the said image processing means are also operable to produce the said composite image signal by mixing the said posture mark signal representing the said desired posture mark with the said organ mark signal and the said ultrasonic image signal generated by said image signal processing means such that the said displaying means display a composite image of the said ultrasonic image, organ mark and posture mark. Since in ultrasonic diagnostic apparatus embodying the present invention, the desired posture and organ marks are selected from a plurality of posture and organ marks and the thus selected marks are displayed on a monitor screen together with the ultrasonic image, a doctor can know more easily and accurately within what organ the ultrasonic wave has been transmitted and the posture of the patient lying on the bed, and thus the diagnosis can be carried out more accurately by monitoring the composite image displayed on the monitor screen. Reference will now be made, by way of example, to the accompanying drawings, wherein: Fig. 1 (described above) shows schematic views representing body marks and probe marks displayed in known ultrasonic diagnostic apparatus; Fig. 2 is a block diagram illustrating the construction of first ultrasonic diagnostic apparatus embodying the present invention; Figs. 3A, 3B and 3C show schematic views representing posture marks for use in apparatus embodying the present invention; Fig. 4 shows a schematic view representing an organ mark for use in apparatus embodying the present invention; Fig. 5 is a block diagram illustrating the construction of second ultrasonic diagnostic apparatus embodying the present invention; Figs. 6A and 6B show schematic views representing organ marks for use in apparatus embodying the present invention; Fig. 7 shows a schematic view representing an organ mark on which an ultrasonic wave transmitting point indicating mark is superimposed; Fig. 8 shows a schematic view for use in explaining the function of the organ mark shown in Fig. 7; Fig. 9 shows a plan view of part of the apparatus shown in Fig. 5; Fig. 10 shows a schematic view of an example of a composite image obtained using apparatus embodying the present invention; Fig. 11 shows a schematic view representing an example of a group of posture marks; Fig. 12 shows a schematic view representing an example of a group of organ marks; Fig. 13 is a block diagram illustrating the construction of third ultrasonic diagnostic apparatus embodying the present invention; Fig. 14 is a block diagram showing the construction of fourth ultrasonic diagnostic apparatus embodying the present invention; and Figs. 15 to 20 show schematic views of examples of composite images obtained using apparatus embodying the present invention. When the apparatus of Fig. 2 is in use, a transmitting pulse is generated by a transmitting/receiving (T-R) circuit 12, under the control of a controller 11, and is supplied to an ultrasonic vibrator (not shown) provided in a distal end of an ultrasonic probe 13 which is suitable for insertion into a cavity of a patient under examination. A pulsatory ultrasonic wave is then transmitted from the ultrasonic probe 13 towardsa cavity wall, and an ultrasonic wave reflected by the cavity wall is received by the ultrasonic vibrator in the probe 13 and is converted into an echo signal. The echo signal is supplied to the transmitting/receiving circuit 12 and is processed thereby in the usual manner. The processed echo signal is then supplied to a digital scan converter (DSC) 14 to which position information is also supplied from the controller 11. In DSC 14 the echo signal is processed and is converted into an ultrasonic image signal. The thus-generated ultrasonic image signal is stored in DSC 14, and is then supplied to a monitor 15 to display thereon an ultrasonic image of the cavity of the patient. It should be noted that the ultrasonic probe 13 may be detachably coupled with a main body 16 of the ultrasonic diagnostic apparatus. In the present embodiment, between the digital scan converter 14 and the monitor 15 there is arranged an image mixing circuit 17. Further, a display mark memory 18 and a mark selection unit 19 are also connected to the controller 11. The mark selection unit 19 may be formed by a keyboard. In the memory 18 there are previously stored a plurality of posture marks 20 as shown in Figs. 3A, 3B and 3C which represent various postures of a patient on a bed, and a plurality of organ marks 21. In Fig. 4 there is shown an example of the organ mark 21 which represents a stomach. In the present embodiment, an operator or doctor manually selects one of the posture marks 20 as well as one of the organ marks 21 by operating the mark selection unit 19. Then, the corresponding posture mark and organ mark are read out of the memory 18 under the control of the controller 11. Then, image signals representing the thus read-out marks are supplied to the mixing circuit 17 and are mixed with the ultrasonic image signal to produce a composite image signal of the ultrasonic image signal and the mark signals. Then, the composite image signal is supplied to the monitor 15 and a composite image of the ultrasonic image and the posture and organ marks 20 and 21 is displayed on a display screen of the monitor. Since in the present embodiment, the operator or doctor knows the posture of the patient on the bed and the organ of the patient under inspection and can manually select a corresponding posture mark 20 and organ mark 21 by operating the mark selection unit 19, such that the selected posture mark 20 and organ mark 21 are displayed on the monitor 15 together with the ultrasonic image, it is easy to know what portion of the patient is being monitored by the ultrasonic probe 13 and from what direction, so that the diagnosis can be performed easily and accurately by monitoring the composite image displayed on the monitor screen. In this case, the composite image signal may be transmitted from the testing room occupied by the patient and operator to the diagnosis room occupied by one or more doctors and the composite image may be displayed on a monitor provided in the diagnosing room. Alternatively, the composite image signal may be recorded on a video tape and the composite signal may be reproduced later on in any desired room. Further the composite image may be recorded on a photographic film and,after developing the film, the diagnosis may be carried out from the composite image on the photographic film. In Fig. 5, which shows second ultrasonic diagnostic apparatus embodying the present invention, portions which are similar to those of the apparatus shown in Fig. 2 are denoted by the same reference numerals as used in Fig. 2. In the apparatus of Fig. 5 there is additionally provided an ultrasonic wave transmitting point indicating mark generating unit 22 for generating a signal which represents an ultrasonic wave transmitting point mark. This unit 22 is connected to the controller 11 and to the image mixing circuit 17. By operating the mark selection unit 19, the unit 22 generates an ultrasonic wave generating point indication signal under the control of the controller 11 and the thus-generated signal is supplied to the image signal mixing circuit 17 and is mixed with the composite image signal of ultrasonic image signal and mark signals. The shape and size of particular organs differ from one another depending on the sex and race of the patient. For instance, the white race has a stomach typically shown by a stomach mark shown in Fig. 6A and the stomach of the yellow race may be typically represented by a stomach mark illustrated in Fig. 6B. In the other words, the shape and size of the stomach of the white race differ from those of the yellow race. Therefore, in the present embodiment, a plurality of organ marks belonging to the same organ are previously stored in the mark memory 18 and any desired one of the organ marks is selected by the mark selection unit 19. The remaining construction of the present embodiment is similar to that of the previous embodiment. As shown in Fig. 10, in the apparatus of Fig. 5 an organ mark 21 is selectively displayed on the monitor 15 together with the ultrasonic image and at the same time a mark 23 for indicating the point from and direction in which the ultrasonic wave is transmitted is displayed in a superimposed manner on the organ mark 21. In this case, when the patient is lying on the bed with the face upward as illustrated by the posture mark 20 shown in Fig. 3A, the ultrasonic wave propagating medium, such as water, in the stomach is at that part of the stomach which is near the back of the patient. That is to say, when a cross-section of the stomach cut along a line X-X in fig. 7 is considered as shown in Fig. 8, it is known that the water is located in an upper portion of the stomach. In this connection it should be noted that in the cross-section of Fig. 8 an upper portion is near the rear side of the patient and lower portion is near the front side of the patient. Therefore, one can easily understand that the ultrasonic image is taken at a part of the stomach which is near the back of the patient. When the patient is lying on the bed with the left side upward as illustrated in Fig. 3B, the water is located in a part of the stomach which is near the right side, and similarly when the patient is lying on the bed with the right side upward as shown in Fig. 3C, the water is located in a part of the stomach which is near the left side. In this manner, the part of the stomach whose ultrasonic image is taken can be easily and accurately known by monitoring the composite image displayed on the monitor 15. Fig. 9 shows in plan an example of the mark selection unit 19. The mark selection unit 19 comprises a group of input keys 51 for entering various kinds of patient data such as the sex and race of the patient, a switch 52 for generating a group of organ marks, a switch 53 for generating a group of posture marks, mark selection switches 54 for selecting organ and posture marks, switches 55 for moving and rotating the ultrasonic wave transmitting point indicating mark 23, and a switch 56 for changing the function of the switches 55 between the linear movement and the rotation. Fig. 10 is a schematic view showing an example of the composite image displayed on the display screen of the monitor 15. On the screen of the monitor 15 there are displayed ultrasonic image 61, gray scale bar 62, and range scale 63. On the monitor screen there are further provide a mark display region 64 for displaying selected posture mark 20 and organ mark 21, and a mark group display region 65 for displaying a group of marks. On the organ mark 21 there is displayed the ultrasonic wave transmitting point indicating mark 23 in superimposition thereon. At first, the switch 53 on the mark selection unit 19 is operated to display a group of posture marks on the mark group display region 65 as depicted in Fig. 11. Then, a desired posture mark is selected by operating any one of the mark selection switches 54, and a selected posture mark 20 is read out of the mark memory 18 and is displayed in the mark display region 64 of the display screen of the monitor. When the switch 52 is operated, the group of organ marks 21 is displayed on the mark group display region 65 as illustrated in Fig. 12. In this case, organ marks corresponding to the previously entered sex and race data of the patient are selectively read out of the mark memory 18. Then, a desired one of the mark selection switches 54 is operated to select a desired organ mark and the thus selected organ mark 21 is read out of the mark memory 18 and is displayed on the mark display region 64 in the display screen. Next the ultrasonic wave transmitting point indicating mark 23 is displayed on the organ mark 21 displayed in the mark display region 64 by suitably operating the linear movement-rotation changing switch 56 as well as the movement-rotation switches 55. That is to say, at first an indication mark in the form of a bar is displayed on the screen. Then, the switch 56 is operated to set the switches 55 into the linear-movement mode and the indication mark is parallelly shifted by operating the switches 55. After the indication mark is shifted into a desired position, the switch 56 is operated to change the mode of the switches 55 into the rotation mode, and the indication mark is rotated by operating the switches 55. In this manner, the composite image including the ultrasonic image 61, posture mark 20, organ mark 21 and ultrasonic wave transmitting point indicating mark 23 as shown in Fig. 10 can be displayed on the display screen of the monitor 15. Therefore, one can understand what part of what organ of the patient is taken as the ultrasonic image, so that a very accurate diagnosis can be performed by monitoring the composite image. In Fig. 13, which shows third ultrasonic diagnostic apparatus embodying the present invention, portions similar to those shown in Fig. 2 are denoted by the same reference numerals as used in Fig. 2. In the apparatus of Fig. 13, the organ mark 21 is automatically, rather than manually, selected. To this end, there is provided a scope code judging device 31 for automatically judging a kind of the ultrasonic probe 13, and in the ultrasonic probe 13 there is provided a scope code generating device. When the ultrasonic prove 13 is coupled with the main body 16, the scope code judging device 31 detects a scope code generated by the scope code generating device provided in the ultrasonic probe 13. The thus detected scope code is supplied to the controller 11. Then, the controller 11 operates to automatically select a desired organ mark from the group of organ marks stored in the memory 18. The remaining construction of the present embodiment is same as that of the first embodiment illustrated in Fig. 2. In the apparatus of Fig. 13, the organ mark is automatically selected by coupling the ultrasonic probe 13 to the main body 16, so that the operation of the operator becomes simple. Further a possible error in the manual selection of the organ mark can be effectively prevented. In fourth ultrasonic diagnostic apparatus embodying the present invention which is shown in Fig. 14, the ultrasonic wave transmitting point indicating mark 23 is automatically generated by detecting the movement of the angle knob (not shown) provided in the ultrasonic probe 13 for moving a distal end of the ultrasonic probe and a length of a portion of an insertion section of the ultrasonic probe 13 which has been inserted into the cavity of the patient. To this end, the ultrasonic probe 13 is constructed to generate up/down and right/left signals in relation to the operation of the angle knob and the length of the insertion section of the probe which has been inserted into the cavity, and in the main body 16 there is arranged a distal end position sensor 41 for detecting the movement of the angle knob of the ultrasonic probe 13 and a point within the cavity up to which the distal end of the probe has been inserted. An output signal of the distal end position sensor 41 is supplied to the controller 11, and the controller controls the ultrasonic wave transmitting point indicating mark generating device 22 to produce automatically an ultrasonic wave transmitting point indicating mark signal related to the operation of the angle knob of the ultrasonic probe and the length of the insertion section of the probe which has been inserted into the cavity. Also in the present embodiment, the manual operation of the operator can be saved and any possible error due to the manual operation can be avoided. In the embodiment illustrated in Fig. 5, a plurality of marks of the same organ belonging to different races are previously stored in the memory 18. Alternatively, however, if appropriate only organ marks which are specific to a single race in whose territory the ultrasonic diagnosing apparatus is to be used need be stored in the mark memory. Figs. 15 to 20 show some examples of the composite image displayed on the display screen of the monitor. It should be noted that in these composite images the posture mark is not included. In Fig. 15, there is displayed an ultrasonic image of a colon having a polyp 106 and at the same time there is displayed a colon mark 103 at a left lower region of the monitor screen. Fig. 16 is an enlarged view of the colon mark 103 shown in Fig. 15. In superimposition of the colon mark there is also shown an ultrasonic wave transmitting point indicating mark 104 indicating a point from and a direction in which the ultrasonic wave is transmitted. In Fig. 17, the ultrasonic image is displayed as a three-dimensional image by processing the echo signal while a distal end of the ultrasonic probe of the radial scanning type is linearly moved within a cavity. In a left lower portion of the display screen, there is also displayed an organ mark 103. Fig. 18 is an enlarged view of the organ mark 103 shown in Fig. 17. The organ mark 103 is also displayed as a simple three-dimensional image and a point of the organ under inspection is displayed by an area mark 105. Fig. 19 is a three-dimensional ultrasonic image which is obtained by rotating the three-dimensional ultrasonic image illustrated in Fig. 17. In a right lower portion of the display screen there is displayed a three-dimensional organ mark 103. As shown in Fig. 20 the organ mark is also rotated in relation to the rotation of the ultrasonic three-dimensional ultrasonic image. In Fig. 16 the position and direction of the ultrasonic wave transmitting point indicating mark 104 may be set by operating a suitable operating member such as a track ball. Further the rotation of the ultrasonic image shown in Figs. 17 and 19 may be performed by operating the track ball. In this case, the organ mark 103 is also rotated accordingly, so that the position and size of the polyp can be judged in an easy and accurate manner. Further the relative position of the polyp with respect to surrounding organs and blood vessels can be understood at a glance, and thus the diagnosis can be performed more accurately and a very large amount of useful data for diagnosis and surgical operations can be obtained. As explained above in detail, since in ultrasonic diagnostic apparatus embodying the present invention, the composite image displayed includes a posture mark, accurate diagnosis is facilitated.

Claims: Ultrasonic diagnostic apparatus comprising: an ultrasonic probe (13) which is insertable into a cavity of a patient and operable, when the apparatus is in use, to transmit an ultrasonic wave towards a wall of the said cavity and to generate an echo signal in dependence upon an ultrasonic wave reflected by the cavity wall; image signal processing circuitry (12) connected to the said ultrasonic probe (13) for receiving the said echo signal and processing the said echo signal to produce an ultrasonic image signal; memory means (18) for storing a plurality of organ marks (21) which represent various organs of the human body; selecting means (19) for selecting a desired organ mark from amongst the said plurality of organ marks (21) to produce an organ mark signal; image processing means (17) for mixing the said organ mark signal representing the said desired organ mark (21) with the said ultrasonic image signal generated by said image signal processing circuitry (12), to produce a composite image signal; and displaying means (15) for receiving said composite image signal and displaying on the basis thereof a composite image of the said ultrasonic image and organ mark (21); characterised in that the said memory means (18) also store a plurality of posture marks (20) which represent postures of a patient under examination, and in that the said selecting means (19) are also operable to select a desired posture mark (20) amongst the said plurality of posture marks (20) to produce a posture mark signal, and in that the said image processing means (17) are also operable to produce the said composite image signal by mixing the said posture mark signal representing the said desired posture mark (20) with the said organ mark signal and the said ultrasonic image signal generated by said image signal processing means (12) such that the said displaying means (15) display a composite image of the said ultrasonic image, organ mark (21) and posture mark (20). Apparatus according to claim 1, wherein said selecting means (19) comprise means for displaying a plurality of organ marks (21) stored in said memory means (18), means for selecting one of the thus displayed organ marks (21), means for displaying said plurality of posture marks (20), and means for selecting one of the thus displayed posture marks (20). Apparatus according to claim 2, wherein said memory means (18) are operable to store a plurality of organ marks (21) belonging to each of a plurality of organs depending upon sex and race. Apparatus according to claim 1, 2 or 3, further comprising means (22) for displaying an ultrasonic wave transmitting point indicating mark, for indicating a point at which the ultrasonic wave is transmitted, in superimposition with the selected and displayed organ mark (21). Apparatus according to claim 4, wherein the said means (22) for displaying the ultrasonic wave transmitting point indicating mark comprise means for displaying a point indication mark, means for parallelly moving the point indication mark and means for rotating the point indication mark. Apparatus according to claim 4, wherein the said means (22) for displaying the ultrasonic wave transmitting point indicating mark comprise a distal end position sensor, for detecting an operation of an angle knob for moving a distal end of the ultrasonic probe (13) as well as the length of the ultrasonic probe (13) which is inserted into the cavity of the patient, and means for generating an ultrasonic wave transmitting point indicating mark signal in response to an output signal of said distal end position sensor. Apparatus according to claim 1, wherein the said ultrasonic probe (13) is detachably coupled with a main body (16) of the apparatus and has an organ indicating means for denoting an organ specific to a relevant ultrasonic probe (13), and wherein the said selecting means (19) comprise means for detecting the said organ denoted by said organ indicating means and means for automatically selecting an organ mark (21) on the basis of an output signal of the said means for detecting the organ denoted by the said organ indicating means.

Inventors: AMENOMORI TAKESHI, AMENOMORI, TAKESHI
Applicants: OLYMPUS OPTICAL CO, OLYMPUS OPTICAL CO., LTD.
Application year: 1992
Main classification: A61B8
IPC codes: G01S7, A61B8, G01N29, H04N7