CN110960187A - Evaluation method of hypertension retinal vascular diseases with different traditional Chinese medicine syndromes - Google Patents

Evaluation method of hypertension retinal vascular diseases with different traditional Chinese medicine syndromes Download PDF

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CN110960187A
CN110960187A CN201911290722.4A CN201911290722A CN110960187A CN 110960187 A CN110960187 A CN 110960187A CN 201911290722 A CN201911290722 A CN 201911290722A CN 110960187 A CN110960187 A CN 110960187A
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chinese medicine
traditional chinese
retinal
image
fundus
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王保和
徐强
张真
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SECOND AFFILIATED HOSPITAL OF TIANJIN UNIVERSITY OF TCM
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • A61B3/12—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for looking at the eye fundus, e.g. ophthalmoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • A61B3/12—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for looking at the eye fundus, e.g. ophthalmoscopes
    • A61B3/1241—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for looking at the eye fundus, e.g. ophthalmoscopes specially adapted for observation of ocular blood flow, e.g. by fluorescein angiography
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • A61B3/14—Arrangements specially adapted for eye photography

Abstract

The invention relates to the technical field of hypertensive retinopathy assessment, in particular to an evaluation method of hypertensive retinopathy of different traditional Chinese medicine syndromes. It includes traditional Chinese medicine syndrome differentiation, retinal blood vessel examination, dynamic and static indexes of summary analysis. In the evaluation method of the different traditional Chinese medicine syndrome type hypertensive retinal vascular diseases, a hypertensive firstly carries out traditional Chinese medicine syndrome differentiation and typing, collects the artery-vein internal diameter ratio, arteriovenous cross signs, vascular exudation and macular region vascular morphology as evaluation indexes, analyzes the positive index difference of each syndrome type as the standard of traditional Chinese medicine typing, provides a foundation for guiding traditional Chinese medicine intervention in the next step, adds retinal vascular fluorescence angiography into the evaluation method, reflects the retinal microcirculation state, embodies the dynamic process, supplements the defect that fundus imaging only reflects the static state, synthesizes the static state result obtained by fundus photography and the dynamic state result obtained by fluorescence angiography for analysis, determines the traditional Chinese medicine typing standard of HRP, and guides the medicine intervention in the next step.

Description

Evaluation method of hypertension retinal vascular diseases with different traditional Chinese medicine syndromes
Technical Field
The invention relates to the technical field of hypertensive retinopathy assessment, in particular to an evaluation method of hypertensive retinopathy of different traditional Chinese medicine syndromes.
Background
The hypertensive retinopathy is an important and common target organ damage of hypertension, currently, the assessment of HRP is mainly completed by a fundus imaging technology, a series of indexes are analyzed by fundus photography to judge the severity of the HRP, but the technical method has certain defects:
1. the static image generated by fundus photography can only reflect the pathological change degree of retinal blood vessels at a specific time, and the dynamic process of pathological state is lacked.
2. Whether the hypertension patients are classified according to modern medicine or differentiated and classified according to traditional Chinese medicine, different blood pressure crowds or different syndrome crowds have different vascular lesion characteristics, only the fundus imaging technology can achieve the summary report of observation indexes, and the fundus imaging technology lacks the function of further classification and classification, so that the guiding value of further refining and medicine intervention on HRP is weakened, and the treatment effect of the part of patients is influenced.
Disclosure of Invention
The invention aims to provide evaluation methods of different traditional Chinese medicine syndrome type hypertensive retinal vascular diseases so as to solve the problems in the background technology.
In order to achieve the purpose, the invention provides an evaluation method of different traditional Chinese medicine syndrome type hypertensive retinal vascular diseases, which comprises the following steps:
s1, syndrome differentiation of traditional Chinese medicine: carrying out traditional Chinese medicine syndrome differentiation and typing on patients with hypertension;
s2, retinal vascular examination: after typing, carrying out inspection, and respectively carrying out retinal blood vessel inspection on each group, wherein each group comprises a fundus photographing module and a retinal fluorescence radiography module;
s3, summarizing and analyzing dynamic and static indexes: and performing integrated analysis on the dynamic and static indexes to formulate a traditional Chinese medicine HRP typing standard.
Preferably, in S1, the syndrome differentiation types of the traditional Chinese medicine include hyperactivity of liver-yang, stagnation of liver-qi, flaring-up of liver-fire, hyperactivity of yin-deficiency and blood stasis of heart.
Preferably, in S2, the fundus camera module includes:
s2.1, acquiring fundus retina images, and acquiring the fundus retina images by adopting a digital fundus camera;
and S2.2, preprocessing the fundus retina image, and processing the fundus retina image.
Preferably, the step of preprocessing the retinal image in S2.2 is as follows:
s2.2.1, lighting equalization, wherein each pixel in the image is equalized, the region of interest is marked as 1, and the other regions are marked as 0, and the formula is as follows:
Figure BDA0002319047750000021
s2.2.2, extracting image details, adopting a filter as a filtering mask, and extracting image details in each direction in the blood vessel image by setting parameters in different directions;
s2.2.3, enhancing image details, and performing Top-hat transformation to obtain details of blood vessel shadow enhancement.
Preferably, in S2.2.2, the filter is a D-Gabor filter, and its functional expression is:
Figure BDA0002319047750000022
in the formula, theta is the filter direction; f is the center frequency of the filtering; x and y are spatial coordinates; sigmax、σyIs a gaussian network space constant along the x-axis, y-axis.
Preferably, in S2.2.3, the Top-hat transformation is defined as:
HAT(f)＝f-fob
wherein o is an on operation operator, b is a structural element, and f is an input gray image.
Preferably, in S2, the retinal fluorescence angiography module outputs retinal artery phase, arteriovenous phase, and venous phase indexes of the retina.
Compared with the prior art, the invention has the beneficial effects that:
1. in the evaluation methods of the different traditional Chinese medicine syndrome type hypertensive retinopathy, a hypertensive firstly carries out traditional Chinese medicine syndrome differentiation and typing, collects the artery-vein internal diameter ratio, the arteriovenous cross signs, the vascular exudation and the vascular morphology in a macular region as evaluation indexes, analyzes the positive index difference of each syndrome type as the standard of traditional Chinese medicine typing, and provides a basis for guiding the traditional Chinese medicine intervention in the next step.
2. In the evaluation method of the different traditional Chinese medicine syndrome type hypertensive retinal vascular diseases, retinal vascular fluorescence angiography is added into the evaluation method to reflect the retinal microcirculation state, embody the dynamic process and supplement the defect that fundus imaging only embodies the static state.
3. In the evaluation method of the different traditional Chinese medicine syndrome type hypertensive retinal vascular diseases, the static result obtained by fundus photography and the dynamic result obtained by fluorescence angiography are synthesized for analysis, the traditional Chinese medicine typing standard of HRP is determined, and the next medicine intervention is guided.
Drawings
FIG. 1 is an overall frame diagram of the present invention;
FIG. 2 is an overall flow diagram of the present invention;
FIG. 3 is a block diagram of a fundus photography process of the present invention;
fig. 4 is a block diagram of a fundus retinal image preprocessing flow of the present invention.
Detailed Description
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 only a part of the embodiments of the present invention, and not all of the embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.
Referring to fig. 1-4, the present invention provides a technical solution:
the invention provides an evaluation method of different traditional Chinese medicine syndrome type hypertensive retinal vascular diseases, which comprises the following steps:
s1, syndrome differentiation of traditional Chinese medicine: carrying out traditional Chinese medicine syndrome differentiation and typing on patients with hypertension;
s2, retinal vascular examination: after typing, carrying out inspection, and respectively carrying out retinal blood vessel inspection on each group, wherein each group comprises a fundus photographing module and a retinal fluorescence radiography module;
s3, summarizing and analyzing dynamic and static indexes: and performing integrated analysis on the dynamic and static indexes to formulate a traditional Chinese medicine HRP typing standard.
In this example, in S1, the syndrome differentiation types of TCM include hyperactivity of liver-yang, stagnation of liver-qi, hyperactivity of liver-fire, yin deficiency and hyperactivity of yang, and heart blood stasis.
Wherein the key points of the syndrome differentiation of the liver-yang hyperactivity are dizziness, distending pain, heaviness of the head and feet, soreness and weakness of the waist and knees, red tongue with little fluid, and wiry or wiry, thready and rapid pulse; the key points of syndrome differentiation of stagnation of liver-qi are dizziness, distending pain, pain with split sensation, red face and eyes, bitter taste in the mouth, irritability, tinnitus, dryness, deafness, insomnia, or burning pain in chest and hypochondrium, dry stool, dark urine, hematemesis, epistaxis, red tongue with yellow coating, and wiry and rapid pulse; the key points of syndrome differentiation of the liver fire flaming up are dizziness, distending pain, tinnitus, red face, conjunctival congestion, swelling and pain, impatience, testiness, vexation, insomnia or dreaminess, bitter taste in the mouth, dry mouth, constipation, short and yellow urine, or hypochondriac pain, epistaxis, hematemesis, women with large menstrual flow, advanced menstruation, red tongue with yellow coating and wiry and rapid pulse; the key points of yin deficiency and yang hyperactivity are tidal fever, red cheeks, night sweat, dysphoria with feverish sensation in the chest, palms and soles, hemoptysis, blurred vision, emaciation or insomnia, numbness and spasm, dysphoria and easy thinking, spermatorrhea, hypersexuality, red and dry tongue and the like; the key points of the differentiation of heart blood stasis and obstruction include deficiency of body qi, fatigue and anxiety, disorder of visceral qi and insufficient heart qi.
Further, in S2, the fundus camera module includes the steps of:
s2.1, acquiring fundus retina images, and acquiring the fundus retina images by adopting a digital fundus camera;
and S2.2, preprocessing the fundus retina image, and processing the fundus retina image.
Wherein, the step of retinal image pre-processing in S2.2 is as follows:
s2.2.1, lighting equalization, wherein each pixel in the image is equalized, the region of interest is marked as 1, and the other regions are marked as 0, and the formula is as follows:
Figure BDA0002319047750000041
in the formula (f)eq(r, c) a gray value of the image at (r, c) after the illumination equalization; f (r, c) is the gray value at (r, c) after the green channel inverse transform of the original image, M is the desired average gray value,
Figure BDA0002319047750000042
is the average value of the image gray levels in the window W.
Since the contrast between retinal blood vessels and the background is weakened by the operation after the illumination equalization, it is necessary to perform enhancement processing on the image to improve the visual effect of the image.
S2.2.2, extracting image details, adopting a filter as a filtering mask, and extracting image details in each direction in the blood vessel image by setting parameters in different directions; the filter adopts a D-Gabor filter, and the functional expression is as follows:
Figure BDA0002319047750000043
in the formula, theta is the filter direction; f is the center frequency of the filtering; x and y are spatial coordinates; sigmax、σyIs a Gaussian network space constant along the x-axis and y-axis, let σx＝σyUsing the real part of the Gabor filter as a filter mask, extracting image details of each direction in the blood vessel image by setting parameters of different directions, and obtaining:
Figure BDA0002319047750000051
in order to extract blood vessel information, 12 filters in different directions are constructed with the mask size of s 1/f, sigma k × s/pi and the angular resolution of 15 degrees, wherein the value of s cannot exceed the maximum width of the blood vessel, the blood vessel size of the retina image is 2-12 pixels, and the retina image is set as I (x, y), then:
Q(x,y,θ)＝I(x,y)*Φ(x,y,θ)；
and the pixel value of each pixel after filtering is the maximum value of the image obtained by filtering each pixel in each direction.
S2.2.3, enhancing image details, and performing Top-hat transformation to obtain details of blood vessel shadow enhancement, wherein the Top-hat transformation is defined as:
HAT(f)＝f-fob
the method comprises the steps that an operator is opened, b is a structural element, f is an input gray image, the image is subjected to Top-hat conversion, target information to be enhanced in the image is determined according to the size and the shape of different structural elements, the thicknesses of eye fundus retinal blood vessels are different, the extending directions of the eye fundus retinal blood vessels are also different, and therefore the structural elements cannot be used for enhancing the blood vessels in different directions and different thicknesses through structural elements in the same direction or in a single scale. In practical application, the structural elements are selected for processing according to the isotropic characteristics of the planar disc-shaped structural elements.
In S2, the retinal fluorescence radiography module outputs retinal artery phase, arteriovenous phase and venous phase indexes of the retina, wherein the retinal artery phase, arteriovenous phase and venous phase are important indexes reflecting retinal microcirculation states, a dynamic process can be embodied, and the defect that fundus imaging only embodies static state is supplemented.
The foregoing shows and describes the general principles, essential features, and advantages of the invention. It will be understood by those skilled in the art that the present invention is not limited to the embodiments described above, and the preferred embodiments of the present invention are described in the above embodiments and the description, and are not intended to limit the present invention. The scope of the invention is defined by the appended claims and equivalents thereof.

Claims (7)

1. The evaluation method of the hypertension retinal vascular diseases with different traditional Chinese medicine syndromes comprises the following steps:
s1, syndrome differentiation of traditional Chinese medicine: carrying out traditional Chinese medicine syndrome differentiation and typing on patients with hypertension;
s2, retinal vascular examination: after typing, carrying out inspection, and respectively carrying out retinal blood vessel inspection on each group, wherein each group comprises a fundus photographing module and a retinal fluorescence radiography module;
s3, summarizing and analyzing dynamic and static indexes: and performing integrated analysis on the dynamic and static indexes to formulate a traditional Chinese medicine HRP typing standard.
2. The method for evaluating the hypertensive retinal vascular diseases with different traditional Chinese medicine syndromes according to claim 1, wherein the method comprises the following steps: in S1, the syndrome differentiation types of TCM include hyperactivity of liver-yang, stagnation of liver-qi, hyperactivity of liver-fire, yin deficiency and hyperactivity of yang, and heart blood stasis.
3. The method for evaluating the hypertensive retinal vascular diseases with different traditional Chinese medicine syndromes according to claim 1, wherein the method comprises the following steps: in S2, the fundus camera module includes:
s2.1, acquiring fundus retina images, and acquiring the fundus retina images by adopting a digital fundus camera;
and S2.2, preprocessing the fundus retina image, and processing the fundus retina image.
4. The method of claim 3, wherein the method comprises the following steps: the step of S2.2 pre-processing a retinal image of the eye is as follows:
s2.2.1, lighting equalization, wherein each pixel in the image is equalized, the region of interest is marked as 1, and the other regions are marked as 0, and the formula is as follows:
Figure FDA0002319047740000011
s2.2.2, extracting image details, adopting a filter as a filtering mask, and extracting image details in each direction in the blood vessel image by setting parameters in different directions;
s2.2.3, enhancing image details, and performing Top-hat transformation to obtain details of blood vessel shadow enhancement.
5. The method for evaluating the hypertensive retinal vascular diseases with different traditional Chinese medicine syndromes according to claim 4, wherein the method comprises the following steps: in S2.2.2, the filter is a D-Gabor filter, and its functional expression is:
Figure FDA0002319047740000021
in the formula, theta is the filter direction; f is the center frequency of the filtering; x and y are spatial coordinates; sigmax、σyIs a gaussian network space constant along the x-axis, y-axis.
6. The method for evaluating the hypertensive retinal vascular diseases with different traditional Chinese medicine syndromes according to claim 4, wherein the method comprises the following steps: in S2.2.3, the Top-hat transformation is defined as:
HAT(f)＝f-fob
wherein o is an on operation operator, b is a structural element, and f is an input gray image.
7. The method for evaluating the hypertensive retinal vascular diseases with different traditional Chinese medicine syndromes according to claim 1, wherein the method comprises the following steps: in the step S2, the retinal fluorescence angiography module outputs retinal artery phase, arteriovenous phase, and venous phase indexes of the retina.
CN201911290722.4A 2019-12-16 2019-12-16 Evaluation method of hypertension retinal vascular diseases with different traditional Chinese medicine syndromes Pending CN110960187A (en)

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN101520888A (en) * 2008-02-27 2009-09-02 中国科学院自动化研究所 Method for enhancing blood vessels in retinal images based on the directional field
CN103458772A (en) * 2011-04-07 2013-12-18 香港中文大学 Method and device for retinal image analysis
US20150324966A1 (en) * 2013-02-19 2015-11-12 Optos Plc Improvements in or relating to image processing
CN107220948A (en) * 2017-05-23 2017-09-29 长春工业大学 A kind of enhanced method of retinal images

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN101520888A (en) * 2008-02-27 2009-09-02 中国科学院自动化研究所 Method for enhancing blood vessels in retinal images based on the directional field
CN103458772A (en) * 2011-04-07 2013-12-18 香港中文大学 Method and device for retinal image analysis
US20150324966A1 (en) * 2013-02-19 2015-11-12 Optos Plc Improvements in or relating to image processing
CN107220948A (en) * 2017-05-23 2017-09-29 长春工业大学 A kind of enhanced method of retinal images

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