CN108836259B - Self-photographing type shared fundus photographing device - Google Patents

Self-photographing type shared fundus photographing device Download PDF

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CN108836259B
CN108836259B CN201810444609.6A CN201810444609A CN108836259B CN 108836259 B CN108836259 B CN 108836259B CN 201810444609 A CN201810444609 A CN 201810444609A CN 108836259 B CN108836259 B CN 108836259B
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吴辉群
于镆铘
张晓峰
董建成
耿兴云
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • A61B3/12Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for looking at the eye fundus, e.g. ophthalmoscopes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • A61B3/14Arrangements specially adapted for eye photography

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Abstract

The invention relates to a self-timer shared fundus camera, comprising: the lower jaw fixing device is used for fixing the lower jaw of the self-checking person; the eye ground imaging device is used for shooting eye ground images of the self-checking person by adopting visual target focusing and automatic focusing technologies and receiving personal information input of the self-checking person; the fundus image quality evaluation module is used for judging whether the fundus images meet preset requirements or not, displaying the fundus images for the self-checking person to select to submit or retake when the fundus images meet the preset requirements, and converting the fundus images into fundus images in a set file format when a submission instruction is selected; the fundus image sharing module is used for storing the personal information of the self-checking person and the corresponding fundus image converted into a set file format for sharing and calling. The invention can realize the self-photographing of the fundus image of the patient, avoid the operation of medical staff, realize the digital shared storage and retrieval of the fundus image data and the report information among hospitals, greatly reduce the repeated examination, save the medical resources and the cost of the patient and be beneficial to the reasonable utilization of the medical information.

Description

Self-photographing type shared fundus photographing device
Technical Field
The invention relates to the technical field of shared medical treatment, in particular to a self-photographing type shared fundus photographing device based on an IHE-XDS integration technology.
Background
The fundus is the posterior tissue within the eyeball and includes: retina, optic disc, macula, and retinal blood vessels. Patients with hypertension, diabetes, nephropathy, etc. can be detected and diagnosed at an early stage by fundus examination. Fundus imaging examination is the most important examination means in the field of ophthalmology, while a fundus camera is an important means for recording retinopathy, and developing general examination of the fundus camera has important significance for early detection and early diagnosis of hypertension, diabetes mellitus and other ophthalmic diseases. At the present stage, medical resources in China are relatively insufficient, and particularly in remote rural areas, the shared fundus examination and medical image sharing system realized by the product can greatly save the medical resources, better save image data of patients and avoid repeated examinations.
In 1997, the north American society of Radiology (RSNA) and the Association of health information and management systems (HIMSS) jointly establish IHE (integration of the healthcare enterprise) to facilitate sharing of medical data between medical institutions, in 2006, 24, the people's republic of china health and family planning committee promulgated by the issuing of "healthcare institute [ 2006 ] 32" notification of inter-medical institution medical examination, medical image review mutual recognition related issues ", to better advance SOAP among hospitals to provide policy support for the system of shared image data, IHE in turn proposes XDS scheme to solve sharing of electronic medical records among different medical institutions [ zheng western, wu-je, xian. IHE XDS shares related issues with medical image area research [ J ] medical health equipment, 2009,30(07):48-50 ] image data account for 80% of medical data, thus the system of sharing of medical image data is also referred to as the IHE-50, which accounts for 80% of medical data, and is an international medical image Communication standard-based on international standards, i.e. international standards for local image sharing, i.e. international standards, i.e. international medical Imaging systems sharing information and medical image sharing information systems, which are developed based on international standards, and international standards for the international medical Imaging standards published by international healthcare institute of medical Imaging standards published international healthcare institute, i.e. international healthcare institute, published international healthcare Imaging standards published by international healthcare institute, published international healthcare Imaging standards published international healthcare institute, published international healthcare Imaging standards published international telecommunication system, published under international telecommunication system, published international telecommunication.
The DICOM messaging protocol is an important guarantee of DICOM image sharing.A DICOM message consists of a command set and an immediately subsequent conditional data set, where the data set describes a patient instance in the real world and the command set describes the type of operations done on this patient instance.Once a connection is established between two application entities, the service is implemented using message exchange.
Conventional fundus cameras rely on trained clinical staff to acquire images. On the basis of the traditional fundus camera, functions of mydriasis-free, automatic focusing, automatic shooting, automatic image optimization, automatic printing and the like have been developed, the intensity of an adjustable flash lamp greatly improves the comfort level and the adaptability of a patient [ Chenjian, Zhengshaohua, Panlin, the rest round ], the remote transmission of images can also be realized by combining the automatic focusing method [ J ]. optical science, 2014,34(11):117 and 128 ], but the collected images are basically acquired by machine-assisted automatic focusing and manually shot by operators, the fundus image data of different hospitals are not shared and checked, the self-photographing type fundus camera does not appear, and the transmission format of the images is not converted into the DICOM medical image standard format, so that the medical image data can be better shared in medical institutions.
Disclosure of Invention
Aiming at the problems and the defects in the prior art, the invention provides a self-photographing type shared fundus camera device which can realize the autonomous high-quality image acquisition of the fundus of a patient, and in addition, the fundus image sharing module based on an IHE-XDS frame can enable the image to be integrated into a medical system.
The invention solves the technical problems through the following technical scheme:
the invention provides a self-photographing type shared fundus photographing device, which is characterized by comprising:
the lower jaw fixing device is used for fixing the lower jaw of the self-checking person;
the eyeground imaging device is used for shooting eyeground images of the self-checking person by adopting red-green sighting mark focusing and automatic focusing technologies, displaying the shot eyeground images and receiving personal information input of the self-checking person;
the fundus image quality evaluation module is used for judging whether the shot fundus images meet the preset requirements or not, displaying the shot fundus images for a self-inspector to select submission or rephotography when the shot fundus images meet the preset requirements, and converting the shot fundus images into fundus images in a set file format when a submission instruction is selected;
and the fundus image sharing module is used for storing the transmitted personal information of the self-checking person and the corresponding fundus image converted into a set file format for sharing and calling.
Preferably, the lower jaw fixing device comprises a lower jaw support and a movable workbench, wherein the lower jaw support is fixed on the movable workbench, and the movable workbench enables the lower jaw support to move up, down, left and right so as to fix the lower jaw of the self-checking person.
Preferably, the fundus imaging device comprises a fundus lens shell, the fundus lens shell comprises a fundus camera, an imaging objective lens, a semi-reflecting and semi-transmitting lens, an eye-catching objective lens, a light source, a red-green sighting target, a condenser lens, an annular diaphragm and an illuminating objective lens, the fundus camera, the imaging objective lens, the semi-reflecting and semi-transmitting lens and the eye-catching objective lens form an image imaging end, and the light source, the red-green sighting target, the condenser lens, the annular diaphragm, the illuminating objective lens, the semi-reflecting and semi-transmitting lens and the eye-catching objective lens form an imaging light path; and a touch display screen is also arranged on the ophthalmoscope shell.
The inspector can observe the inspection result immediately after automatically shooting the image and perform personal information input through the touch display screen. The template of two types of modes can be automatically displayed on the display screen, wherein the first type is an optic disc center type, the second type is a macula lutea center type, an examiner can compare a shot image with the template to ensure that an obtained fundus image must contain the optic disc and the macula lutea, and the definition of fundus blood vessels and the image brightness meet the requirements required by clinical diagnosis.
Preferably, the fundus image quality evaluation module is used for calculating a definition evaluation value of the fundus image so as to automatically judge whether the fundus image is clear or not;
Figure BDA0001656835030000041
Figure BDA0001656835030000042
wherein i represents the i-th fundus image, M and N are the number of lines and columns of the fundus image, respectively, and f(x, y) denotes an image region selected corresponding to the i-th fundus image, SiDenotes a sharpness evaluation value of the ith fundus image, max { S }iDenotes taking the maximum value of the sharpness in all fundus images for normalization, FiThe sharpness evaluation value of the i-th fundus image after normalization is shown.
Preferably, the mobile phone App client or the hospital system client queries the fundus image data of the patient shot by each self-photographing type shared fundus camera.
Preferably, the file format is set to be DICOM file format.
On the basis of the common knowledge in the field, the above preferred conditions can be combined randomly to obtain the preferred embodiments of the invention.
The positive progress effects of the invention are as follows:
the invention can realize the self-photographing of the fundus image of the patient, avoid the operation of medical staff, realize the digital shared storage and retrieval of the fundus image data and the report information among hospitals, greatly reduce the repeated examination, save the medical resources and the cost of the patient and be beneficial to the reasonable utilization of the medical information.
Drawings
Fig. 1 is a block diagram of a self-photographing type shared fundus camera according to a preferred embodiment of the present invention.
Fig. 2 is a block diagram showing the structure of a fundus imaging apparatus according to a preferred embodiment of the present invention.
Fig. 3 is a diagram illustrating the automatic focusing process of the fundus oculi according to the preferred embodiment of the present invention.
FIG. 4 is a diagram illustrating a fundus image sharing mode according to a preferred embodiment of the present invention.
Fig. 5 is a diagram illustrating the sharing effect of fundus images according to the preferred embodiment of the present invention.
FIG. 6 is a flow chart of the use of the self-photographing shared fundus camera according to the preferred embodiment of the present invention.
Detailed Description
In order to make the objects, technical solutions and advantages of the embodiments of the present invention clearer, the technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are some, but not all, embodiments of the present invention. All other embodiments, which can be obtained by a person skilled in the art without any inventive step based on the embodiments of the present invention, are within the scope of the present invention.
As shown in fig. 1, the present embodiment provides a self-photographing type shared fundus photographing apparatus including: a mandible fixing device 1, a fundus imaging device 2, a fundus image quality evaluation module 3 and a fundus image sharing module 4.
The mandibular fixation device 1 is used to secure the mandible of a self-test person. The lower jaw fixing device 1 comprises a lower jaw support and a movable workbench, wherein the lower jaw support is fixed on the movable workbench, and the movable workbench enables the lower jaw support to move up, down, left and right so as to fix the lower jaw of a self-checking person.
The eyeground imaging device 2 is used for shooting eyeground images of the self-checking person by adopting red-green sighting mark focusing and automatic focusing technologies, displaying the shot eyeground images and receiving personal information input of the self-checking person.
As shown in fig. 2, the fundus imaging device 2 comprises a fundus housing, the fundus housing comprises a fundus camera 21, an imaging objective lens 22, a half-reflecting and half-transmitting lens 23, an eye-catching objective lens 24, a light source 25, a red-green sighting target 26, a condenser lens 27, an annular diaphragm 28 and an illumination objective lens 29, the fundus camera 21, the imaging objective lens 22, the half-reflecting and half-transmitting lens 23 and the eye-catching objective lens 24 form an image imaging end, and the light source 25, the red-green sighting target 26, the condenser lens 27, the annular diaphragm 28, the illumination objective lens 29, the half-reflecting and half-transmitting lens 23 and the eye-catching objective lens 22 form an imaging optical path; the ophthalmoscope housing is also provided with a touch display screen, wherein 30 in fig. 2 represents the eyes of a self-testing person.
The inspector can observe the inspection result immediately after automatically shooting the image and perform personal information input through the touch display screen. The template of two modes can be automatically displayed on the touch display screen, the first mode is an optic disc center type, the second mode is a macula lutea center type, a self-inspector can compare a shot image with the template to ensure that an acquired fundus image must contain the optic disc and the macula lutea, and the definition of fundus blood vessels and the image brightness meet the requirements required by clinical diagnosis.
Imaging angle settings were initially defined as: 60 ° and 45 °.
The fundus image quality evaluation module 3 is used for judging whether the shot fundus images meet the preset requirements or not, displaying the shot fundus images for a self-inspector to select submission or rephotography when judging that the shot fundus images meet the preset requirements, and converting the shot fundus images into fundus images in a DICOM file format when selecting a submission instruction.
Compared with the traditional medical staff for manually shooting and framing and judging whether the eyeground image is clear or not, the invention changes the traditional fixed lower jaw support into the movably adjusted lower jaw support, adopts the red-green sighting mark to be arranged in the outer layer of the flash lamp, and utilizes the eyeground camera automatic focusing algorithm (see figure 3) to judge that the focusing is accurate when the sighting mark is clearly displayed on the retina, thereby increasing the comfort of the patient and improving the efficiency during automatic focusing.
After obtaining the fundus image, in order to judge whether the image quality meets the inspection requirement, an image definition evaluation function based on regional contrast is adopted in combination with a signal to noise ratio method: in each defined area, calculating the difference between the maximum value and the minimum value of the gray level in the area, dividing the difference by the maximum value to obtain the area contrast of the area, calculating the area contrast of all pixels and averaging the area contrast to obtain a normalized definition evaluation function value, namely
Figure BDA0001656835030000071
Wherein i represents the i-th image in the auto-focusing process, FiRepresenting a sharpness evaluation function value, M and N representing a row value and a column value sampled by division of a region (sub-window), and dev (x, y) being a region contrast defined as
Figure BDA0001656835030000072
In the formula (f)Δ(x, y) denotes the selected image area, max [ ·]And min [. C]Respectively representing that each pixel point in the image area takes the maximum value and the minimum value;
by analyzing the usual sharpness evaluation function, the gradient vector square function has better sensitivity, i.e.
Figure BDA0001656835030000073
In the formula, F represents a sharpness evaluation function value, and M and N are the number of rows and columns of the image, respectively. And combining the idea of a gradient vector square function to improve the sharpness evaluation function based on the regional contrast, namely:
Figure BDA0001656835030000081
Figure BDA0001656835030000082
wherein i represents the i-th fundus image during auto-focusing, and f(x, y) denotes an image region selected corresponding to the i-th fundus image, SiDenotes a sharpness evaluation value of the ith fundus image, max { S }iDenotes taking the maximum of the sharpness in all images for normalization, FiExpressing the definition evaluation value of the normalized ith image so as to finish whether the image is shot clearlyAnd (6) performing dynamic judgment.
The fundus image sharing module 4 is used for storing the personal information of the self-checking person and the corresponding fundus image converted into a set file format for sharing and calling.
Considering that the self-timer shared fundus camera devices may be distributed in different terminals or systems, and fundus images stored by the self-timer shared fundus camera devices of different models cannot interoperate with medical information in the future, an eye image sharing module (fig. 4) is designed, firstly, a DICOM file format of the fundus images is defined, the collected images are automatically packaged into a DICOM format according to a DICOM3.0 international standard, so that the fundus images can be better transmitted and displayed in different regions of different models, when image data is called, a mechanism for accessing and reproducing the DICOM objects from an HTM L page or an XM L document through an HTTP or HTTPs protocol and by using identifiers of DICOM is adopted, the mechanism is used for solving the problem that the DICOM objects are accessed in an internet environment, a user inputs a UR L in a browser address column, a request is sent to a server, the server receives the request, and then the image or report required by the server side is sent back to a browser side according to the parameters provided in the UR L, the image or report required by the server side, and the conventional mobile phone image data such as a mobile phone record, a mobile phone, and the like, wherein the mobile phone, a.
As shown in fig. 6, the following specifically describes the flow of use of the self-tapping shared fundus camera:
step 1: downloading a mobile phone APP, logging in after registration, selecting the device, and starting a fundus camera;
step 2: selecting left and right eyes, adjusting the heights of a mandible support and a camera body by a key, placing the mandible into the mandible support, automatically focusing a fundus image self-photographing type acquisition device, acquiring an image after a flash lamp and a red and green visual target appear in a visual field, accurately focusing the visual target, displaying the image by a display for a patient to select to submit or rephoto after the image is screened to be qualified by a fundus image quality evaluation module, and automatically selecting whether the patient prints or not by the patient, and then acquiring another eyeball fundus image according to a similar method;
and step 3: packaging the fundus image into a DICOM format, submitting the fundus image, and storing the submitted patient information and fundus pictures corresponding to the patient information into a database of the fundus image;
and 4, step 4: the fundus image data shot by the patient in each self-photographing type shared fundus camera is inquired through the mobile phone App client or the hospital system client.
While specific embodiments of the invention have been described above, it will be appreciated by those skilled in the art that these are by way of example only, and that the scope of the invention is defined by the appended claims. Various changes and modifications to these embodiments may be made by those skilled in the art without departing from the spirit and scope of the invention, and these changes and modifications are within the scope of the invention.

Claims (5)

1. A self-photographing type shared fundus photographing apparatus, comprising:
the lower jaw fixing device is used for fixing the lower jaw of the self-checking person;
the eyeground imaging device is used for shooting eyeground images of the self-checking person by adopting red-green sighting mark focusing and automatic focusing technologies, displaying the shot eyeground images and receiving personal information input of the self-checking person;
the fundus image quality evaluation module is used for judging whether the shot fundus images meet the preset requirements or not, displaying the shot fundus images for a self-inspector to select submission or rephotography when the shot fundus images meet the preset requirements, and converting the shot fundus images into fundus images in a set file format when a submission instruction is selected;
the eye fundus image sharing module is used for storing the transmitted personal information of the self-checking person and the corresponding eye fundus image converted into a set file format for sharing and calling;
the fundus imaging device comprises a fundus lens shell, the fundus lens shell comprises a fundus camera, an imaging objective lens, a semi-reflecting and semi-transmitting lens, an eye-catching objective lens, a light source, a red-green sighting target, a condenser lens, an annular diaphragm and an illuminating objective lens, the fundus camera, the imaging objective lens, the semi-reflecting and semi-transmitting lens and the eye-catching objective lens form an image imaging end, and the light source, the red-green sighting target, the condenser lens, the annular diaphragm, the illuminating objective lens, the semi-reflecting and semi-transmitting lens and the eye-catching objective lens form an imaging light path; and a touch display screen is also arranged on the ophthalmoscope shell.
2. A self-photographing shared fundus camera according to claim 1, wherein said mandibular fixing device comprises a mandibular rest fixed to a movable table and a movable table enabling the mandibular rest to move up, down, left and right to fix the mandible of the examiner.
3. A self-timer shared fundus camera according to claim 1, wherein said fundus image quality evaluation module is configured to calculate a sharpness evaluation value of the fundus image, thereby completing an automatic determination of whether the fundus image is sharp or not.
4. A self-timer shared fundus camera according to claim 1, wherein the fundus image data taken by the patient at each self-timer shared fundus camera is queried by the mobile phone App client or the hospital system client.
5. The self-photographing shared fundus camera apparatus according to claim 1, wherein a DICOM file format is set to a common standard format.
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