CN113171053A - Endoscopic surgery blood vessel enhancement detection method fused with near-infrared imaging - Google Patents

Endoscopic surgery blood vessel enhancement detection method fused with near-infrared imaging Download PDF

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CN113171053A
CN113171053A CN202110457495.0A CN202110457495A CN113171053A CN 113171053 A CN113171053 A CN 113171053A CN 202110457495 A CN202110457495 A CN 202110457495A CN 113171053 A CN113171053 A CN 113171053A
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image
blood vessel
infrared
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human body
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周文举
朱一丁
王海宽
尼相荣
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ALTON (SHANGHAI) MEDICAL INSTRUMENTS Co.,Ltd.
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/313Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes
    • A61B1/3137Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes for examination of the interior of blood vessels
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00002Operational features of endoscopes
    • A61B1/00004Operational features of endoscopes characterised by electronic signal processing
    • A61B1/00009Operational features of endoscopes characterised by electronic signal processing of image signals during a use of endoscope
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/06Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements
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    • A61B1/0676Endoscope light sources at distal tip of an endoscope

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Abstract

The invention relates to a near-infrared imaging fused endoscopic surgery blood vessel enhancement detection method, wherein the method comprises the following steps: (A) the endoscope near infrared light source is turned off, the panchromatic light source is turned on, and the panchromatic light source is used for collecting a human body cavity color image; (B) turning on a near-infrared light source of the endoscope, turning off a full-color light source, and collecting a near-infrared image of a human body cavity; (C) carrying out gray level processing and noise reduction processing on the infrared image, and extracting a blood vessel region in the infrared image of the human body cavity by utilizing the penetrating action of near infrared light on human body tissues and the absorption action of hemoglobin on the near infrared light; (D) fusing the extracted blood vessel region image with the color image to make the blood vessel visualization in the color image more obvious; (E) repeating the steps at a high speed, and outputting the endoscope video image with the enhanced blood vessel area. By adopting the detection method, the problem that the imaging of the blood vessel and the bleeding point of the body cavity is not obvious in the endoscopic surgery is solved, and the success rate of the surgery is improved.

Description

Endoscopic surgery blood vessel enhancement detection method fused with near-infrared imaging
Technical Field
The invention relates to the technical field of medical equipment, in particular to the technical field of endoscopic detection, and specifically relates to a near-infrared imaging fused endoscopic surgery blood vessel enhancement detection method.
Background
With the continuous development of medical equipment, endoscopes are applied more and more widely in various hospitals and clinics. The endoscope is a medical detection instrument with a special structure, and can be used for directly observing pathological changes of organs, determining the parts and the ranges of the organs, taking pictures, sampling or brushing pictures, collecting images or images and transmitting the images to a display device by sending the endoscope into a human body from a cavity channel of the human body to inspect internal diseases. Displayed on the display screen and enlarged. With the help of the endoscope, doctors can better find the pathological changes of internal tissues, the diagnosis accuracy is greatly improved, and some treatments can be carried out through the endoscope.
The traditional endoscope usually adopts a color camera or a gray scale camera to collect images of an internal cavity of a human body, but because the internal cavity is narrow, the camera can not clearly collect blood vessel images of the inner wall of the cavity, if the operation is not proper, the blood vessel of the inner wall can be broken, the images collected by the endoscope are seriously influenced, and great difficulty is brought to the endoscopic operation.
Compared with visible light, the near infrared light (with the wavelength of 700nm-900nm) can penetrate deeper human tissues, and the deoxyhemoglobin in venous blood has obviously higher near infrared light energy absorption than surrounding blood vessel tissues such as fat, melanin and the like, so that the contrast between blood vessels and the surrounding tissues can be obviously improved by adopting a near infrared light imaging method, and a clearer blood vessel structure image can be obtained.
Disclosure of Invention
The invention aims to overcome the defects of the prior art and provide the endoscopic surgery blood vessel enhancement detection method which is clear in imaging and convenient and fast to operate and integrates near infrared imaging. The method can not only detect the position of the blood vessel in the human body cavity, but also enhance the image of the blood vessel region, help the user to avoid the blood vessel region during the operation, and avoid the difficulty caused by improper operation.
In order to achieve the purpose, the invention idea of the invention is as follows: the infrared image of the inside of a human body is shot through the endoscope, blood vessels and capillary vessels which are not easy to detect in the image are extracted by utilizing the absorption effect of the deoxyhemoglobin on near infrared light, and then the blood vessels are marked on a color image acquired by the endoscope.
The invention discloses an endoscopic surgery blood vessel enhancement detection method fused with near infrared imaging, which comprises the following steps:
the detection method for the infrared blood vessel enhancement in the endoscopic surgery is mainly characterized by comprising the following steps:
(A) the endoscope near infrared light source is turned off, the panchromatic light source is turned on, and the panchromatic light source is used for collecting a human body cavity color image;
(B) turning on a near-infrared light source of the endoscope, turning off a full-color light source, and collecting a near-infrared image of a human body cavity;
(C) carrying out gray level processing and noise reduction processing on the infrared image, and extracting a blood vessel region image in the infrared image of the human body cavity by utilizing the penetrating action of near infrared light on human body tissues and the absorption action of hemoglobin on the near infrared light;
(D) fusing the extracted blood vessel region image with the color image to make the blood vessel visualization in the color image more obvious;
(E) and D, repeatedly executing the step A to the step D at a high speed, and outputting the endoscope video image after the blood vessel enhancement.
Preferably, the endoscope structure comprises:
the front end of the endoscope comprises a full-color light source which is used for collecting the color image of the human body cavity;
the front end of the endoscope comprises a near-infrared light source with the wavelength of 700nm-900nm, and the near-infrared light source is used for collecting the human body cavity infrared image;
the endoscope adopts a camera which can simultaneously acquire a color image and an infrared image and is used for acquiring images in a human body cavity.
Preferably, the acquiring the enhanced image of the human body lumen specifically comprises the following steps:
(3-1) the endoscope light source controls the alternative opening and closing of the infrared light source and the panchromatic light source respectively;
(3-2) the endoscope light source is turned on and off respectively, and color images and infrared images are collected alternately through the endoscope;
(3-3) the image chip forms a color image video stream and an infrared image video stream by separating the color image and the infrared image which are alternately collected, and matches the color image video stream and the infrared image video stream in a time sequence;
and (3-4) extracting a blood vessel region in the infrared image by processing the infrared image, and fusing the blood vessel region with the color image to enhance the blood vessel region in the color image of the human body cavity.
Preferably, the method for enhancing the blood vessel region in the color image of the body lumen specifically comprises the following steps:
(4-1) image segmentation: capturing a blood vessel image of a human body cavity by an infrared camera, performing primary segmentation, extracting the blood vessel image, and segmenting a blood vessel region;
(4-2) contrast adjustment: adjusting the contrast through an image histogram to enhance the contrast of the blood vessel region;
(4-3) convolution processing: sharpening the blood vessel, highlighting the gray level jump of the blood vessel edge and other parts of the image, and enabling the gray level jump of the blood vessel edge to be obvious;
(4-4) edge detection: adopting a vertical edge extraction algorithm for the sharpened blood vessel image, assisting in edge detection at an angle of 45 degrees, and accurately determining a blood vessel boundary;
(4-5) denoising: removing hole noise in the blood vessel image and filling holes; communicating the small blood vessel missing area, and removing the interference generated by the boundary to make the blood vessel continuously visible;
(4-6) image fusion: and fusing the noise-reduced infrared blood vessel image with the color image to mark blood vessel regions on the wall of the human body cavity and subcutaneous imperceptible capillary vessels.
By adopting the near-infrared imaging fused endoscopic surgery blood vessel enhancement detection method, the near-infrared image and the color image of the human body cavity are collected, the blood vessel enhancement infrared image is obtained by utilizing the absorption effect of hemoglobin on near-infrared light and the penetration effect of the near-infrared light on human body tissues, and the color image is fused to generate the blood vessel enhancement endoscopic image. The endoscope can effectively solve the problem that the imaging of the blood vessel and the bleeding point of the body cavity is not obvious in the endoscope operation, can help doctors to carry out more accurate operation in the operation, and improves the precision and the success rate of the endoscope operation.
Drawings
FIG. 1 is a flow chart of the endoscopic procedure infrared enhanced blood vessel detection method of the present invention.
Fig. 2 is a flow chart of blood vessel image extraction of the endoscopic surgery infrared blood vessel enhancement detection method of the present invention.
Detailed Description
In order to more clearly describe the technical contents of the present invention, the following further description is given in conjunction with specific embodiments.
Before describing in detail embodiments that are in accordance with the present invention, it should be noted that the terms "comprises," "comprising," or any other variation thereof, are intended to cover a non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements does not include only those elements but may include other elements not expressly listed or inherent to such process, method, article, or apparatus.
The endoscopic surgery infrared blood vessel enhancement detection method comprises the following steps:
(A) the endoscope near infrared light source is turned off, the panchromatic light source is turned on, and the panchromatic light source is used for collecting a human body cavity color image;
(B) turning on a near-infrared light source of the endoscope, turning off a full-color light source, and collecting a near-infrared image of a human body cavity;
(C) carrying out gray level processing and noise reduction processing on the infrared image, and extracting a blood vessel region image in the infrared image of the human body cavity by utilizing the absorption effect of hemoglobin on near infrared light;
(D) fusing the extracted blood vessel region image with the color image to make the blood vessel visualization in the color image more obvious;
(E) and D, repeatedly executing the step A to the step D at a high speed, and outputting the endoscope video image after the blood vessel enhancement.
In a preferred embodiment of the present invention, the endoscope includes:
the front end of the endoscope comprises a full-color light source which is used for collecting the color image of the human body cavity;
the front end of the endoscope comprises a near-infrared light source with the wavelength of 700nm-900nm, and the near-infrared light source is used for collecting the human body cavity infrared image;
the endoscope adopts a camera which can simultaneously acquire a color image and an infrared image and is used for acquiring images in a human body cavity.
As a preferred embodiment of the present invention, the acquiring of the enhanced image of the body lumen specifically includes the following steps:
(3-1) the endoscope light source controls the alternative opening and closing of the infrared light source and the panchromatic light source respectively;
(3-2) the endoscope light source is turned on and off respectively, and color images and infrared images are collected alternately through the endoscope;
(3-3) the image chip forms a color image video stream and an infrared image video stream by separating the color image and the infrared image which are alternately collected, and matches the color image video stream and the infrared image video stream in a time sequence;
and (3-4) extracting a blood vessel region in the infrared image by processing the infrared image, and fusing the blood vessel region with the color image to enhance the blood vessel region in the color image of the human body cavity.
As a preferred embodiment of the present invention, the method for enhancing the blood vessel region in the color image of the body lumen specifically comprises the following steps:
(4-1) image segmentation: capturing a blood vessel image of a human body cavity by an infrared camera, performing primary segmentation, extracting the blood vessel image, and segmenting a blood vessel region;
(4-2) contrast adjustment: adjusting the contrast through an image histogram to enhance the contrast of the blood vessel region;
(4-3) convolution processing: sharpening the blood vessel, highlighting the gray level jump of the blood vessel edge and other parts of the image, and enabling the gray level jump of the blood vessel edge to be obvious;
(4-4) edge detection: adopting a vertical edge extraction algorithm for the sharpened blood vessel image, assisting in edge detection at an angle of 45 degrees, and accurately determining a blood vessel boundary;
(4-5) denoising: removing hole noise in the blood vessel image and filling holes; communicating the small blood vessel missing area, and removing the interference generated by the boundary to make the blood vessel continuously visible;
(4-6) image fusion: and fusing the noise-reduced infrared blood vessel image with the color image to mark blood vessel regions on the wall of the human body cavity and subcutaneous imperceptible capillary vessels.
In a specific embodiment of the present invention, the technical solution is specifically realized by the following means:
(1) the camera capable of simultaneously collecting the color image and the infrared image is adopted to collect the image in the human body cavity.
(2) A full-color light source is adopted to collect color images in the body cavity.
(3) A near-infrared light source with the wavelength of 700-900 nm is adopted to collect red infrared images in the human body cavity.
(4) In order to continuously collect images to form a video, the light source drive is used for controlling the switch of the light source, when the full-color light source is started, the camera collects color images, and when the infrared light source is started, the infrared images are collected.
(5) The frame rate of the endoscope camera is 60 frames, wherein 30 frames of color images and 30 frames of infrared images are acquired every second, and the color images and the infrared images are alternately shot.
(6) The image chip forms a color image video stream and an infrared image video stream by separating the color image and the infrared image which are alternately collected, and matches the color image video stream and the infrared image video stream in a time sequence.
(7) By processing the infrared image, the blood vessel region in the infrared image is extracted by utilizing the absorption effect of hemoglobin on near infrared light. It can be realized by the flow shown in fig. 2, and the specific steps are as follows:
and (7-1) image segmentation, namely capturing an infrared image of the blood vessel of the human body by using an infrared camera, converting the image into a gray image, and performing primary segmentation on the blood vessel of the lumen of the human body by using an OTSU algorithm. And calculating a threshold value between the foreground and the background of the human body cavity image through an OTSU algorithm, and setting the background gray value to zero, wherein the foreground is kept unchanged. The algorithm can effectively extract the wall area of the tube cavity and remove background and partial noise.
And (7-2) contrast adjustment, namely adjusting the contrast by utilizing the image histogram so that the brightness can be better distributed on the histogram, and thus the contrast of the blood vessel can be enhanced without influencing the overall contrast.
(7-3) sharpening the blood vessel to highlight the blood vessel edge and the gray level jump of other parts of the image; the jump of the edge gray level of the blood vessel is obvious, and the preprocessing is performed for the extraction of the blood vessel.
The convolution process is implemented by the following equation:
Figure BDA0003041001030000051
wherein f is an original image, h is a template with a preset value adjusted according to previous experience, and g is an image of the original image after convolution processing;
set the convolution kernel to
Figure BDA0003041001030000052
The sharpening effect is better.
And (7-4) edge detection, namely, adopting a vertical sobel edge extraction algorithm to the sharpened blood vessel image, and assisting in sobel edge detection at an angle of 45 degrees to accurately determine the vein boundary.
(7-5) denoising, namely removing hole noise in the blood image by using morphological closed operation and filling holes; and communicating the small blood vessel missing area by using a morphological connected domain method, and removing the interference generated by the boundary to ensure that the blood vessel is continuously visible.
(8) And (4) image fusion, namely fusing the blood vessel image subjected to noise reduction with a color image, and marking a blood vessel area and a capillary vessel which is not easy to perceive. Because the extracted blood vessel image is an image which only contains blood vessel information after image processing, the image is matched with the color image through feature points, the infrared blood vessel image can be accurately mapped to the position of the blood vessel of the internal cavity channel, and the accurate coincidence of the image and the color image is realized.
In an embodiment of the present invention, please refer to fig. 1, which shows a method for detecting infrared blood vessel enhancement in endoscopic surgery, wherein the method comprises the following steps:
step S1: and (3) color image acquisition, namely, sending the endoscope into the human body cavity, starting a panchromatic light source by using a light source controller, and acquiring a color image in the human body cavity.
Step S2: and infrared image acquisition, namely, a light source controller is used, a panchromatic light source is closed, a near-infrared light source is opened, and an infrared image in a human body cavity channel is acquired.
Step S3: and (4) extracting a blood vessel image, namely processing a blood vessel region in the infrared image and separating the blood vessel region from the background.
Referring to fig. 2, step S3 specifically includes the following steps:
(3-1) image segmentation: and calculating a threshold value between the foreground and the background of the human body cavity image through an OTSU algorithm, and setting the background gray value to zero, wherein the foreground is kept unchanged. The algorithm can effectively extract the wall area of the tube cavity and remove background and partial noise. The algorithm can effectively extract the wall area of the tube cavity and remove background and partial noise.
(3-2) contrast adjustment: the contrast is adjusted by utilizing the image histogram, the contrast of the blood vessel region is enhanced, and the brightness can be better distributed on the histogram, so that the contrast of the blood vessel can be enhanced without influencing the overall contrast.
(3-3) convolution processing: sharpening the blood vessel to highlight the blood vessel edge and the gray level jump of other parts of the image; the jump of the edge gray level of the blood vessel is obvious, and the preprocessing is performed for the extraction of the blood vessel.
The convolution process is implemented by the following equation:
Figure BDA0003041001030000061
wherein f is an original image, h is a template with a preset value adjusted according to previous experience, and g is an image of the original image after convolution processing;
set the convolution kernel to
Figure BDA0003041001030000062
The sharpening effect is the best.
(3-4) edge detection: and (3) adopting a vertical sobel edge extraction algorithm for the sharpened blood vessel image, assisting the sobel edge detection at an angle of 45 degrees, and accurately determining the vein boundary.
(3-5) denoising: removing hole noise in the blood image by using morphological closing operation, and filling holes; communicating the small blood vessel missing areas by using a morphological connected domain method, and removing interference generated by boundaries to enable blood vessels to be continuously visible;
step S4: and (4) image fusion, namely fusing the extracted blood vessel image with a color image, and marking the blood vessel part and the inconspicuous capillary vessel. The extracted blood vessel image is matched with the color image through the characteristic points, so that the infrared blood vessel image can be accurately mapped to the position of the blood vessel of the internal cavity channel, and the accurate coincidence of the infrared blood vessel image and the color image is realized.
Step S5: and (5) video output, namely outputting the fused color image formed video to a display screen.
Any process or method descriptions in flow charts or otherwise described herein may be understood as representing segments or portions that include one or more steps for performing a particular process, and the scope of the preferred embodiments of the present invention includes additional implementations in which functions may be performed out of the order shown or discussed, including substantially concurrently or in reverse order, depending on the functionality involved, as would be understood by those reasonably skilled in the art of implementation of the present invention.
In the description herein, references to the description of the term "an embodiment," "some embodiments," "an example," "a specific example," "an embodiment," or "an implementation," etc., mean that a particular feature, structure, material, or characteristic described in connection with the embodiment or example is included in at least one embodiment or example of the invention. In this specification, the schematic representations of the terms used above do not necessarily refer to the same embodiment or example. Furthermore, the particular features, structures, materials, or characteristics described may be combined in any suitable manner in any one or more embodiments or examples.
By adopting the near-infrared imaging fused endoscopic surgery blood vessel enhancement detection method, the near-infrared image and the color image of the human body cavity are collected, the blood vessel enhanced infrared image is obtained by utilizing the absorption effect of hemoglobin on the near-infrared light, and the color image is fused to generate the blood vessel enhanced endoscopic image. The endoscope can effectively solve the problem that the imaging of the blood vessel and the bleeding point of the body cavity is not obvious in the endoscope operation, can help doctors to carry out more accurate operation in the operation, and improves the precision and the success rate of the endoscope operation.
In this specification, the invention has been described with reference to specific embodiments thereof. It will, however, be evident that various modifications and changes may be made thereto without departing from the broader spirit and scope of the invention. The specification and drawings are, accordingly, to be regarded in an illustrative rather than a restrictive sense.

Claims (4)

1. A method for detecting infrared vascular enhancement in endoscopic surgery, said method comprising the steps of:
(A) the endoscope near infrared light source is turned off, the panchromatic light source is turned on, and the panchromatic light source is used for collecting a human body cavity color image;
(B) turning on a near-infrared light source of the endoscope, turning off a full-color light source, and collecting a near-infrared image of a human body cavity;
(C) carrying out gray level processing and noise reduction processing on the infrared image, and extracting a blood vessel region image in the infrared image of the human body cavity by utilizing the penetrating action of near infrared light on human body tissues and the absorption action of hemoglobin on the near infrared light;
(D) fusing the extracted blood vessel region image with the color image to make the blood vessel visualization in the color image more obvious;
(E) and D, repeatedly executing the step A to the step D at a high speed, and outputting the endoscope video image with the enhanced blood vessel area.
2. The method of claim 1, wherein the endoscope is configured to:
the front end of the endoscope comprises a full-color light source which is used for collecting the color image of the human body cavity;
the front end of the endoscope comprises a near-infrared light source with the wavelength of 700nm-900nm, and the near-infrared light source is used for collecting the human body cavity infrared image;
the endoscope adopts a camera which can simultaneously acquire a color image and an infrared image and is used for acquiring images in a human body cavity.
3. The method for detecting infrared blood vessel enhancement in endoscopic surgery according to claim 2, wherein the step of acquiring the enhanced image of the body lumen specifically comprises the steps of:
(3-1) the endoscope light source controls the alternative opening and closing of the infrared light source and the panchromatic light source respectively;
(3-2) the endoscope light source is turned on and off respectively, and color images and infrared images are collected alternately through the endoscope;
(3-3) the image chip forms a color image video stream and an infrared image video stream by separating the color image and the infrared image which are alternately collected, and matches the color image video stream and the infrared image video stream in a time sequence;
and (3-4) extracting a blood vessel region in the infrared image by processing the infrared image, and fusing the blood vessel region with the color image to enhance the blood vessel region in the color image of the human body cavity.
4. The endoscopic surgery infrared blood vessel enhancement detection method as defined in claim 3, wherein the blood vessel region in the color image of the enhanced body lumen specifically comprises the following steps:
(4-1) image segmentation: capturing a blood vessel image of a human body cavity by an infrared camera, performing primary segmentation, extracting the blood vessel image, and segmenting a blood vessel region;
(4-2) contrast adjustment: adjusting the contrast through an image histogram to enhance the contrast of the blood vessel region;
(4-3) convolution processing: sharpening the blood vessel, highlighting the gray level jump of the blood vessel edge and other parts of the image, and enabling the gray level jump of the blood vessel edge to be obvious;
(4-4) edge detection: adopting a vertical edge extraction algorithm for the sharpened blood vessel image, assisting in edge detection at an angle of 45 degrees, and accurately determining a blood vessel boundary;
(4-5) denoising: removing hole noise in the blood vessel image and filling holes; communicating the small blood vessel missing area, and removing the interference generated by the boundary to make the blood vessel continuously visible;
(4-6) image fusion: and fusing the noise-reduced infrared blood vessel image with the color image to mark blood vessel regions on the wall of the human body cavity and subcutaneous imperceptible capillary vessels.
CN202110457495.0A 2021-04-27 2021-04-27 Endoscopic surgery blood vessel enhancement detection method fused with near-infrared imaging Pending CN113171053A (en)

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN114041737A (en) * 2021-11-16 2022-02-15 四川大学华西医院 Imaging device applied to endoscope
CN115100147A (en) * 2022-06-24 2022-09-23 华中科技大学协和深圳医院 Intelligently switched spinal endoscope system, device and computer readable medium

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN114041737A (en) * 2021-11-16 2022-02-15 四川大学华西医院 Imaging device applied to endoscope
CN115100147A (en) * 2022-06-24 2022-09-23 华中科技大学协和深圳医院 Intelligently switched spinal endoscope system, device and computer readable medium
CN115100147B (en) * 2022-06-24 2023-10-24 华中科技大学协和深圳医院 Intelligent switching spinal endoscope system, intelligent switching spinal endoscope device and computer readable medium

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