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1 CT 画 像 を 用 いた 肺 の 呼 吸 機 能 の 定 量 化 * ** * Quantification of the Respiratory Activity of the Lung using CT Images Takayuki HASHIMOTO* Caihua WANG**,and Jun MASUMOTO* Abstract We have developed a system to analyze the respiratory activity of the lung using CT images. This analysis includes functions to automatically extract the lung region from several phases of chest CT images, register the different respiratory phases, and obtain a motion vector field. This enables an overlay display of the low attenuation areas, the quantification of the expansion rate of the lung, and the measurement of local movement. With these functions, we can visualize the local respiratory activity, which was previously difficult to observe. Using this system, we hope to obtain indicators that are effective for studying the areas from which respiratory diseases originate, their severity, and their causes. 1. はじめに 2. 従 来 の 呼 吸 機 能 の 診 断 方 法 本 誌 投 稿 論 文 ( 受 理 2014 年 11 月 27 日 ) * * ** ** 28 CT 画 像 を 用 いた 肺 の 呼 吸 機 能 の 定 量 化

2 2.1 呼 吸 機 能 検 査 (スパイロメトリー) 2.2 CT 画 像 ( 吸 気 肺 )による 診 断 2.3 SPECT 画 像 による 診 断 3. 肺 の 動 態 解 析 の 仕 組 み 3.1 位 置 合 わせ 技 術 3.2 位 置 合 わせ 結 果 の 可 視 化 Fig. 1 Mechanism for the registration of the images Fig. 3 Difference image Fig. 2 Difference image FUJIFILM RESEARCH & DEVELOPMENT (No ) 29

3 4. 肺 の 呼 吸 動 作 の 定 量 化 4.1 低 吸 収 域 表 示 4.2 移 動 の 可 視 化 4.3 膨 張 率 の 可 視 化 Fig. 4 LAA display 30 CT 画 像 を 用 いた 肺 の 呼 吸 機 能 の 定 量 化

4 Fig. 5 Moving line Fig. 6 Expansion rate per unit area 参考文献 の区域に分離されているが この区域も加味する事で 各区 域単位での換気能力を観察できるようになる 本システムで は 位置合わせ結果から特定の領域単位で膨張率を計算 可 視化することができる Fig. 6 に 吸気画像の膨張率を表示した結果を示す 呼気 に対する吸気の膨張率を表示しているため 肺野は全体的に 膨張しており 一方で血管や気管支部分は膨張していないた め 肺野との色の違いから走行を確認することができる 5. まとめ 1) 日本呼吸器学会 COPD ガイドライン第 2 版作成委員会 編. COPD( 慢性閉塞性肺疾患 ) 診断と治療のためのガイ ドライン. 第 2 版, 日本呼吸器学会, 2004, 137p. 2) 厚 生 労 働 省. 人 口 動 態 調 査. toukei/list/81-1.html, (accessed ). 3) World Health Organization. World Health Statistics health_statistics/en_whs08_full.pdf, (accessed ). 今回開発した肺の動態機能解析は CT 画像から肺の動態 4) Mattes, David; Haynor, David R.; Vesselle, Hubert; よび要因の診断をサポートする 3 次元画像診断支援システム multimodality image registration. SPIE Proc. 2001, を可視化して 肺内部の疾患の部位の特定や その重症度お である 今後は 肺野に対するさらに新しい解析機能の追加 に加え 気管支でも動態解析を実施できるような改良などを 行う予定である SYNAPSE VINCENT が 呼吸器の臨床現場に広く導入され COPD などの呼吸器疾患の診断および治療になくてはならな いシステムとなるよう 今後も開発を進めたい FUJIFILM RESEARCH & DEVELOPMENT (No ) Lewellyn, Thomas K.; Eubank, William. Nonrigid Medical Imaging 2001: Image Processing, 4322, p ) Cao, Yan; Miller, M.I.; Winslow, R. L.; Younes, L. Large deformation diffeomorphic metric mapping of vector fields. IEEE Transactions on Medical Imaging. 2005, 24(9), p

5 商 標 について 32 CT 画 像 を 用 いた 肺 の 呼 吸 機 能 の 定 量 化

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