DE19640807A1 - Noninvasive optical detection of oxygen supply to e.g. brain or liver - Google Patents

Noninvasive optical detection of oxygen supply to e.g. brain or liver

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Publication number
DE19640807A1
DE19640807A1 DE1996140807 DE19640807A DE19640807A1 DE 19640807 A1 DE19640807 A1 DE 19640807A1 DE 1996140807 DE1996140807 DE 1996140807 DE 19640807 A DE19640807 A DE 19640807A DE 19640807 A1 DE19640807 A1 DE 19640807A1
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Germany
Prior art keywords
detector
light
signals
device according
tissue
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Ceased
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DE1996140807
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German (de)
Inventor
Klaus Dipl Phys Abraham-Fuchs
Helmut Dipl Phys Reichenberger
Oliver Dipl Phys Dr Schuetz
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Siemens AG
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Siemens AG
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Priority to DE1996140807 priority Critical patent/DE19640807A1/en
Publication of DE19640807A1 publication Critical patent/DE19640807A1/en
Application status is Ceased legal-status Critical

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/145Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • A61B5/1455Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters
    • A61B5/14551Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters for measuring blood gases
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/42Detecting, measuring or recording for evaluating the gastrointestinal, the endocrine or the exocrine systems
    • A61B5/4222Evaluating particular parts, e.g. particular organs
    • A61B5/4244Evaluating particular parts, e.g. particular organs liver
    • GPHYSICS
    • G01MEASURING; TESTING
    • G01NINVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N21/00Investigating or analysing materials by the use of optical means, i.e. using infra-red, visible or ultra-violet light
    • G01N21/17Systems in which incident light is modified in accordance with the properties of the material investigated
    • G01N21/47Scattering, i.e. diffuse reflection
    • G01N21/49Scattering, i.e. diffuse reflection within a body or fluid
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2562/00Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
    • A61B2562/02Details of sensors specially adapted for in-vivo measurements
    • A61B2562/0233Special features of optical sensors or probes classified in A61B5/00
    • A61B2562/0242Special features of optical sensors or probes classified in A61B5/00 for varying or adjusting the optical path length in the tissue
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/145Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • A61B5/1455Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters
    • A61B5/14551Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters for measuring blood gases
    • A61B5/14553Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters for measuring blood gases specially adapted for cerebral tissue
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/72Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7203Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal
    • A61B5/7207Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal of noise induced by motion artifacts
    • A61B5/721Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal of noise induced by motion artifacts using a separate sensor to detect motion or using motion information derived from signals other than the physiological signal to be measured
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/72Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7271Specific aspects of physiological measurement analysis
    • A61B5/7285Specific aspects of physiological measurement analysis for synchronising or triggering a physiological measurement or image acquisition with a physiological event or waveform, e.g. an ECG signal

Abstract

The measurement is made with a beam (9) emitted from a laser (5) of suitable wavelength (500 to 1200 nm) through a beam-splitter (14) to the organ (10) concerned. The reflected (reference) portion of the beam is directed at a phantom (15) whose back-scatter is measured by a matrix detector (17) similar to that (8) associated with the organ. Electronic circuits (18,12) convey the measurements to a processor (13) which separates the O2 saturation signal originating in the organ from the interference arising from the overlying tissue.

Description

Klinisch angewandt werden nichtinvasive Verfahren der Oxime trie in großem Umfang bei der sogenannten Pulsoximetrie, bei der z. non-invasive method of the oximes are used clinically trie extensively in the so-called pulse oximetry, wherein z. B. ein Finger mit Licht geeigneter Wellenlängen durch strahlt wird. B. a finger is illuminated with light of appropriate wavelengths. Ebenso ist die Überwachung der Sauerstoffversor gung der Gehirnoberfläche, z. Likewise, monitoring the Sauerstoffversor is supply the brain surface, eg. B. des Fötus während der Geburt durch auf der Kopfhaut applizierte optische Sensoren bekannt (US 5,494,032). B. the fetus during childbirth by known applied on the scalp optical sensors (US 5,494,032).

Aufgabe der Erfindung ist es, eine Vorrichtung zur nichtinva siven optischen Erfassung der Sauerstoffversorgung von Organen wie z. The object of the invention is a device for nichtinva immersive optical detection of the oxygen supply of organs such. B. Gehirn oder Leber, sowie des Föten, zu entwickeln, wenn diese durch relativ dicke Gewebeschichten vom Detektor getrennt sind. to develop as brain or liver, and the fetuses, if they are separated from the detector by relatively thick layers of tissue.

Diese Aufgabe ist erfindungsgemäß gelöst durch die Merkmale des Patentanspruches 1. This object is inventively achieved by the features of claim 1.

Basis der Erfindung ist, die Sauerstoffversorgung eines Or gans, wie z. The basis of the invention, the oxygen supply of a goose Or such. B. des Gehirns, der Leber oder auch eines ungebo renen Kindes, nichtinvasiv durch Oximetrie mittels Laserlicht geeigneter Wellenlängen zu diagnostizieren. As the brain, the liver or a ungebo renen child non-invasively diagnose oximetry by means of laser light of the appropriate wavelengths.

Genutzt wird dabei die Eigenschaft, daß Gewebe relativ trans parent für sichtbares Licht, NIR- und IR-Licht ist. a characteristic that is relatively tissue trans parent for visible light, NIR and IR light is being used. Durch Wahl geeigneter Wellenlängen (mindestens zwei) ist es daher mög lich, die Gewebeoxigenierung zu bestimmen (z. B. Pulsoxime trie). By selecting suitable wavelengths (at least two), it is therefore possible, please include to determine the tissue oxygenation (z. B. Pulsoxime trie). Da bei der nichtinvasiven Oximetrie zur Diagnose der Sauerstoffversorgung z. As in noninvasive oximetry for the diagnosis of oxygenation for. B. des ungeborenen Kindes relativ dicke Gewebeschichten durchstrahlt werden müssen, kann die sehr hohe Streueigenschaft des Gewebes für Licht im oben ge nannten Wellenlängenbereich nicht vernachlässigt werden. As the unborn child relatively thick layers of tissue to be irradiated, the very high scattering property of the fabric can not be neglected for light in the above named ge wavelength range.

Die Erfindung ist nachfolgend anhand eines in der Zeichnung dargestellten Ausführungsbeispiels näher erläutert. The invention is explained in more detail with reference to an embodiment shown in the drawing. Es zeigen: Show it:

Fig. 1 eine schematische Darstellung einer Vorrichtung nach der Erfindung und Fig. 1 is a schematic representation of a device according to the invention, and

Fig. 2 das Blockschaltbild für die Vorrichtung gemäß Fig. 1. Fig. 2 shows the block diagram for the apparatus of FIG. 1.

In der Fig. 1 ist ein Meßobjekt 1 dargestellt, das durch eine Schicht 2 von der Körperoberfläche getrennt ist. In FIG. 1, a measurement object 1 is shown, which is separated by a layer 2 of the body surface. Die Schicht 2 ist in eine tieferliegende Schicht 3 und eine oberflächennahe Schicht 4 aufgeteilt. The layer 2 is divided into a lower layer 3, and a near-surface layer. 4 Zur Messung ist eine Laser-Lichtquelle 5 vorgesehen, die einen Lichtstrahl aussendet, der entweder di rekt oder über eine Faseroptik 6 auf die Körperoberfläche 7 gerichtet wird. For measurement, a laser light source 5 is provided, which emits a light beam that is directed either di rectly or through an optical fiber 6 on the body surface. 7 Das Laserlicht wird gestreut und von einem Ma trix-Detektor 8 erfaßt und in entsprechende elektrische Si gnale gewandelt. The laser light is scattered and detected by a Ma trix-detector 8 and converted into corresponding electrical Si gnale. Die Lichtquelle 5 kann auch von mehreren Ein zel-Lichtquellen, z. The light source 5 can also be of a plurality of light sources A zel, z. B. Dioden, gebildet sein. B. diodes formed his.

Die Fig. 2 zeigt den von der Lichtquelle 5 ausgesandten Licht strahl 9 , der auf den Patienten 10 auftrifft. Fig. 2 shows the light emitted from the light source 5 light beam 9 incident on the patient 10. Das rückge streute Licht (Pfeile 11 ) wird vom Detektor 8 erfaßt und über eine Elektronik 12 einer digitalen Auswerteeinheit 13 zuge führt, die die Lichtquelle 5 steuert. The rückge scattered light (arrows 11) is detected by the detector 8 and fed via a lead 13 electronics 12 of a digital processor which controls the light source. 5

Die Fig. 2 zeigt eine Ausführungsform mit einem Strahlteiler 14 , der einem kalibriertem Meßphantom 15 einen Referenzstrahl zuführt. Fig. 2 shows an embodiment with a beam splitter 14, which supplies a calibrated measurement phantom 15 a reference beam. Das vom Meßphantom 15 rückgestreute Licht (Pfeile 16 ) wird von einem ebenfalls als Matrix ausgebildetem Detektor 17 erfaßt und entsprechende Signale durch eine Elektronik 18 der Auswerteeinheit 13 zugeführt. The backscattered by the measurement phantom 15 light (arrows 16) is detected by a trained also as a matrix detector 17 and corresponding signals supplied by electronics 18 to the evaluation unit. 13

Aufgrund der starken Streuung im Gewebe durchläuft das Licht einen näherungsweise bananenförmigen Gewebebereich vom Ein strahlpunkt zum Detektionspunkt. Due to the strong scattering in the tissue the light passes through an approximately banana-shaped area of ​​tissue from a beam spot to the detection point. Die mittlere Eindringtiefe hängt dabei wesentlich vom Sender-Detektor-Abstand ab, dh je größer der Sender-Detektor-Abstand ist, um so größer ist die mittlere Eindringtiefe des detektierten Lichtes. The mean penetration depth depends essentially from the transmitter-detector distance from, ie, the greater is the transmitter-detector distance, the greater the average depth of penetration of the detected light.

Mittels der Diffusionstheorie ist es möglich, aus den Meßdaten rückzurechnen auf optischen Streu- und Absorptionskoeffizien ten Using the diffusion theory, it is possible, from the measured data to be recalculated on optical scattering and Absorptionskoeffizien th

Mit R(ρ) ist die Intensität des rückgestreuten Lichtes im Ab stand ρ vom Sender bezeichnet, I₀ ist die applizierte Lichtin tensität, With R (ρ) is the intensity of the backscattered light is from stand ρ designated by the transmitter, I o is intensity light in the applied,

µ′ s der reduzierte Streukoeffizient, μ 's, the reduced scattering coefficient,

und A der Reflexionsfaktor, abhängig vom Brechungsindex von Gewebe. and A is the reflection factor, depending on the refractive index of tissue.

Für eine quantitative Bestimmung ist jedoch unter anderem die Kenntnis der applizierten Lichtleistung I₀ notwendig. For a quantitative determination, however, among other things, the knowledge of the applied light power I o is necessary. Dieses Problem kann wie folgt umgangen werden: Es wird vorgeschlagen, das Licht der Lichtquelle 5 aufzuteilen, so daß bei genau be kanntem Teilungsverhältnis This problem can be circumvented as follows: It is proposed to divide the light from the light source 5, so that when exactly be kanntem division ratio

der eine Teilstrahl 9 das Meßobjekt durchläuft, der Referenzstrahl 16 , z. of a partial beam 9 passes through the test object, the reference beam 16, for example. B. bei glei cher Optrodenanordnung wie am Meßobjekt, dh gleichem Optro denabstand, das kalibrierte Meßphantom 15 mit bekannten opti schen Parametern ( Fig. 2). B. when having equivalent Optrodenanordnung as the object to be measured, that same Optro denabstand, the calibrated measurement phantom 15 with known optical rule parameters (Fig. 2). Durch geeignete Auswertung der rückgestreuten Intensitäten im Abstand ρ z. By suitable evaluation of the backscattered intensities at a distance z ρ. B. B.

werden Schwankungen der Lichtquelle 5 eliminiert und haben dadurch keinen Einfluß mehr auf die Bestimmung der opti schen Parameter. fluctuations of the light source 5 are eliminated, and thereby have no influence on the determination of the optical specific parameters. Mit dieser Meßkonfiguration ist es dann mög lich, bei homogenen Proben die unbekannten optischen Eigen schaften (Absorptionskoeffizient, reduzierter Streukoeffizi ent) quantitativ zu bestimmen, indem mehrere Messungen bei verschiedenen Optrodenabständen durchgeführt werden. With this measurement configuration, it is then possible, please include, for homogeneous samples the unknown properties optical properties (absorption coefficient, reduced Streukoeffizi ent) to determine quantitatively by several measurements are carried out at various Optrodenabständen.

Es wird vorgeschlagen, bei mehreren Wellenlängen obige Messun gen durchzuführen, da dann aus den optischen Eigenschaften des Meßobjektes bei den entsprechenden Wellenlängen der Oxigenie rungsgrad des Meßobjektes bestimmt werden kann. It is proposed at several wavelengths above measure ments to perform because then it can be determined from the optical properties of the test object at the respective wavelengths of the Oxigenie approximate degree of the measurement object.

Um der unterschiedlichen Gewebezusammensetzung am lebenden Ob jekt Rechnung zu tragen, wird vorgeschlagen, mit obiger Meß anordnung bis zu einem Abstand von typisch einigen Zentimetern von der Lichtquelle in Inkrementen von typischerweise einigen Millimetern das rückgestreute Licht zu detektieren, in der Da tenanalyse mindestens je zwei Meßpunkte zu einem Auswertein tervall zusammenzufassen und für jedes Auswerteintervall die mittleren optischen Gewebeparameter zu bestimmen ( Fig. 1). To allow for the different tissue composition on living Whether ject bill, it is proposed with the above measuring arrangement up to a distance of typically a few centimeters from the light source in increments of typically a few millimeters to detect the backscattered light in the Da tenanalyse least two each measuring points a Auswertein summarize interval and to determine the average optical tissue parameters for each evaluation interval (Fig. 1).

Im Auswerteintervall mit kleinen Sender-Detektor-Abständen von z. In the evaluation interval with small transmitter-detector separations of z. B. 5 mm bis 10 mm erstreckt sich die bananenförmige Licht verteilung im wesentlichen z. B. 5 mm to 10 mm, the banana-shaped light distribution extends substantially z. B. auf die unter der Haut lie gende Fettschicht. As the lie under the skin constricting layer of fat. Entsprechend werden deren optische Parame ter bestimmt, wenn in diesem Auswerteintervall bei mehreren Sender-Detektor-Abständen die rückgestreute Lichtintensität detektiert wird. Accordingly, the optical parame ter are determined when the back-scattered light intensity is detected in the evaluation interval in several transmitter-detector separations. Im nächstgrößeren Auswerteintervall erfaßt die Lichtverteilung sowohl die oberflächennahe Fettschicht als auch z. In the next largest evaluation interval the light distribution detects both the near-surface layer of fat and z. B. den tieferliegenden Bauchmuskel. As the deeper abdominal muscle. Wird nun auch in diesem Auswerteintervall bei mehreren Sender-Detektor-Abstän den die rückgestreute Lichtintensität detektiert, wird obige Auswertung optische Absorptions- und Streukoeffizienten lie fern, die eine gewichtete Mittelung der entsprechenden Gewebe schichten darstellen. If now in this evaluation interval with several transmitter-detector issues newsletters the backscattering light intensity detected above evaluation is optical absorption and scattering coefficients lie remote representing layers a weighted averaging of the corresponding tissue.

Da die optischen Eigenschaften der oberflächennahen Schicht 4 bei kleinen Abständen bestimmt wurden, können aus den Daten bei größeren Abständen die optischen Eigenschaften der tiefer liegenden Schicht berechnet werden. Since the optical properties of the near-surface layer 4 were determined at small distances, the optical properties of the lower layer can be calculated from the data at greater distances. Durch sukzessives Auswer ten der folgenden Auswerteintervalle lassen sich somit für jede Gewebeschicht die optischen Parameter bestimmen und wenn, wie vorgeschlagen, zusätzlich bei mehreren geeigneten Wellen längen gemessen wird, läßt sich auch der Oxigenisierungszu stand bestimmen. By successively Auswer the following evaluation intervals th thus be determine the optical parameters for each tissue layer, and if, as proposed, in addition with more suitable wave lengths is measured, also the Oxigenisierungszu stand can be determined.

Vorgeschlagen wird, obiges Verfahren für mindestens zwei unab hängige Lichtwege durchzuführen, deren Signale korreliert aus gewertet werden. is proposed to carry out the above method for at least two inde pendent light paths whose signals are correlated from counted. Als unabhängige Lichtwege wird verstanden, daß z. As an independent light paths is understood that such. B. die eine Meßreihe mit entsprechender Sender-Empfän ger-Anordnung links am Bauch der Mutter durchgeführt wird, die zweite gleichzeitig rechts am Bauch. B. a series of measurements with a corresponding transmitter-ger receptions and seminars assembly is carried out on the mother's abdomen to the left, at the same time the second right abdomen. Als unabhängige Lichtwege wird auch verstanden, z. As an independent light paths is also understood z. B. am Patienten die eine Meßreihe mit Sender-Detektor in Richtung oben nach unten durchzuführen, die andere Meßreihe z. to carry out on the patient as a series of measurements with a transmitter-detector in the direction of top to bottom, the other set of measurements z. B. mit Sender-Detektor in Richtung links nach rechts. B. with transmitter-detector in the direction left to right.

Eine weitere Ausführungsform der Erfindung besteht darin, mit nur einem Sender, aber z. A further embodiment of the invention is, with only a transmitter, but z. B. einem Detektorarray in x-Richtung und einem zweiten Detektorarray in y-Richtung Oximetrie an Or ganen oder am Föten durchzuführen. B. Ganen a detector array in the x direction and a second detector array in the y direction at oximetry Or or perform the fetuses.

Eine weitere Ausführungsform der Erfindung besteht darin, mit einem zweidimensionalen Detektorarray die rückgestreuten Lichtintensitäten als Funktion des Sender-Detektor-Abstandes zu erfassen. A further embodiment of the invention is to detect a two-dimensional detector array, the backscattered light intensities as a function of transmitter-detector distance. Die Position des Senders kann dabei am Rand des zweidimensionalen Detektorarrays liegen oder zentral, wobei in geeigneter Weise das Senderlicht durch entsprechende Vorrich tungen (z. B. Bohrung im Detektorarray) dem Meßobjekt zuge führt wird. The position of the transmitter can lie on the edge or the two-dimensional detector array centrally, wherein suitably the transmitter light through the Vorrich (z. B. bore in the detector array) obligations supplied to the object to be measured is lead.

Als Sonderfall wird folgende Ausführung vorgeschlagen: Da bei größeren Sender-Detektor-Abständen die optischen Eigenschaften oberflächennaher Schichten zwischen Lichteintrittszone und Lichtaustrittszone verschieden sein können, wird vorgeschla gen, die gleiche Messung durchzuführen, jedoch Lichteinstrahl punkt und Detektionspunkt zu vertauschen. This execution is proposed as a special case: As for larger transmitter-detector separations, the optical properties of near surface layers between the light entry zone, and light emission zone can be different, it is gen pre schla to perform the same measurement, however, to exchange light projection point and the detection point. Technisch läßt sich das z. Technically, the z can. B. wie folgt realisieren: Das Licht wird von der Licht quelle mittels Faser zum Meßobjekt geführt, entsprechend das zu detektierende Licht mittels Faser zum Detektor. The light is guided from the light source by means of fiber to the measurement object, according to the light to be detected by means of the fiber to the detector. B. realized as follows Durch z. By z. B. einen optischen Schalter lassen sich dann sehr schnell Ein strahl- und Detektionspunkt vertauschen. As an optical switch can then quickly swap a jet- and detection point.

Um die Meßanordnung unempfindlich gegen Umgebungslicht zu ma chen, wird vorgeschlagen, die Lichtsignale in der Intensität zu modulieren (lock in-Technik). The measuring arrangement insensitive to ambient light to ma Chen, it is proposed that the light signals in intensity to modulate (in lock-technique). Dadurch ist es auch möglich, während der Messung mit mehreren Wellenlängen gleichzeitig zu arbeiten, wenn deren Modulationsfrequenz leicht unterschied lich ist, z. Thereby, it is also possible during the measurement of multiple wavelengths to work simultaneously when the modulation frequency is slightly different Lich, z. B. 10 mHz plus/minus einige kHz. B. 10 mHz plus / minus a few kHz.

Um die Meßanordnung unempfindlich gegen Störungen quasiperi odischer Vorgänge, wie Atmung oder Herzaktivität des Patien ten, bzw. von Mutter und Fötus bedingten Störeinflüssen wie Abstands- oder Lageänderungen, zu machen, wird vorgeschlagen, die Messungen mit der Atemfrequenz synchronisiert durchzufüh ren und auszuwerten und/oder mit EKG oder Puls zu korrelieren. The measuring arrangement th insensitive to disturbances quasiperi odic processes, such as respiration or heart activity of the patien, and mother and the fetus caused interferences as distance or positional changes to make, it is proposed that the measurements with the respiratory frequency synchronized durchzufüh ren and evaluate and / to correlate or ECG or pulse.

Um bei Messungen am Föten aus dem Meßsignal das fötale und das mütterliche Oxigenierungssignal separieren zu können, wird vorgeschlagen, über bekannte Verfahren (Ultraschall, fötaler Herzschall oder EKG) die Messung zusätzlich mit dem Herzschlag des Kindes zu synchronisieren. In order to separate the fetal and the maternal Oxigenierungssignal when measured in fetuses from the measurement signal, it is proposed to synchronize by known methods (ultrasound, fetal heart sound or ECG) measurement in addition to the heartbeat of the child.

Vorgeschlagen wird, Lichtquelle (Sender) bzw. Detektoren (Empfänger) bzw. die entsprechende Faseroptik mit anderen Ap plikatoren zu kombinieren, wie is proposed to combine with other plikatoren Ap light source (transmitter) and detector (receiver) or the corresponding optical fiber, such as

  • a) Ultraschallwandler (B-Bild zur Abstandsmessung von der Haut bis zur Organoberfläche, z. B. Cortex, Leber, Kopf oder Rücken des Föten) a) ultrasonic transducer (B-mode image for measuring the distance from the skin to the organ surface, e.g., B. cortex, liver, head or spine of the fetus)
  • b) Elektroden für mütterliches/kindliches EKG b) electrodes for maternal / infantile ECG
  • c) Druckaufnehmer für Wehendruck c) for pressure transducer pressure contractions
  • d) Atemsensor d) respiratory sensor

Zur Realisierung wird folgendes festgehalten: To realize the following is noted:

  • 1. Die Erfindung betrifft eine Vorrichtung zur Untersuchung von Gewebe mit Licht unterschiedlicher Wellenlängen. 1. The invention relates to an apparatus for examining tissue with light of different wavelengths.
    Derartige Vorrichtungen können mit sichtbarem, NIR- oder IR-Licht arbeiten. Such devices can operate with visible, NIR or IR light. Die Wellenlänge des sichtbaren Lichtes liegt zwischen 380 nm und 780 nm, die von NIR-Licht, dh Nah-Infrarot-Licht, zwischen 780 nm und 1500 nm und die von IR-Licht, also infrarotem Licht, zwischen 1500 nm und 1 mm, wobei für die Vorrichtung der eingangs genannten Art der Wellenlängenbereich von 500 nm bis 1200 nm besonders geeignet ist. The wavelength of visible light is between 380 nm and 780 nm, of NIR light, that is, near-infrared light between 780 nm and 1500 nm and thus infrared IR light, light between 1500 nm and 1 mm being particularly suitable for the device of the type mentioned in the wavelength range of 500 nm to 1200 nm.
  • 2. Als Lichtquelle kommen z. 2. The light source for coming. B. Laserdioden oder LEDs mit geeigneter Emissionswellenlänge in Frage. As laser diodes or LEDs with appropriate emission wavelength in question.
  • 3. Die Ankopplung des Lichtes an das Meßobjekt kann z. 3. The coupling of light to the test object for can. B. direkt oder mit Lichtleiter/Faseroptik realisiert werden. B. be implemented directly or with fiber / fiber optics.
  • 4. Detektion des rückgestreuten Lichtes in verschiedenen Abständen, z. 4. Detection of the backscattered light at different distances, eg. B. in 5 mm-Abständen, von Sender-Detektor- Abstand 5 mm bis größer 150 mm, gleichzeitig oder seriell. B. 5 mm intervals, of the transmitter-detector distance 5 mm up to greater than 150 mm, simultaneously or serially.
  • 5. Die Detektoren können direkt am Meßobjekt angekoppelt sein oder aber das rückgestreute Licht wird ebenfalls mit Glasfasern aufgenommen und zu den Detektoren geleitet. 5. The detectors may be directly coupled to the device under test or the backscattered light is also incorporated with glass fiber and guided to the detectors. Als Detektoren kommen entsprechende Anordnungen von bekannten, empfindlichen und schnellen Lichtempfängern in Frage. As detectors appropriate arrangements of well-known, sensitive and rapid light receivers come into question. Besonders vorteilhaft sind Arrays von Detektoren, wie sie bei Photodioden, aber auch Avalanche-Photodioden verfügbar sind. Particularly advantageous are arrays of detectors as they are available at photodiodes, but also avalanche photodiodes. Ahnliches gilt für Multianodenphotomultiplier bzw. ortsempfindliche Photomultiplier, die mehrere Detektoren in einer Röhre vereinen. The same is true for Multianodenphotomultiplier or position-sensitive photomultiplier which combine a plurality of detectors in a tube.
  • 6. Zur Unterdrückung des Fremdlichtsignals wird die lock-in- Technik angewandt, dh Modulation der Lichtintensität mit bis zu mehreren MHz, wobei die Lichtquellen I t bis I n mit Modulationsfrequenzen f₁ bis f n betrieben werden. 6. To suppress the ambient light signal, the lock-in technique is used, that is, modulation of the light intensity up to several MHz, wherein the light sources to I t I n with modulation frequencies f₁ be operated to f n.
  • 7. Wenn die rückgestreuten optischen Signale eine kritische Schwelle unterschreiten, z. 7. If the backscattered optical signals fall below a critical threshold, eg. B. wenn der die Lichtquelle enthaltende Applikator sich vom Meßobjekt gelöst hat, erfolgt eine automatische Sicherheitsabschaltung der Lichtquellen (Laserschutz). B. when the applicator containing the light source has come off the object to be measured, an automatic safety shut-off of the light sources (laser protection).
  • 8. Digitalisierung der einzelnen spektralen rückgestreuten Lichtanteile mittels eines ADCs im Multiplex-Verfahren oder mittels mehrerer ADCs gleichzeitig, um im Computer durch geeignete Algorithmen die Signale dann entsprechend auszuwerten. 8. digitization of the individual spectral backscattered light components by means of an ADC in the multiplex method, or by means of several ADCs simultaneously to then evaluate the computer through suitable algorithms, the signals accordingly.
  • 9. Digitalisierung des Atmungssignals, gemessen z. 9. digitization of the respiratory signal measured for. B. mit einem Atemsensor, mittels ADC, um die optischen Meßsignale auf Atmung von Mann/Frau triggern zu können, dh Atmung Mann/Frau synchrones Mitteln der optischen Meßsignale. B. with a breath sensor, by means of the ADC in order to trigger the optical measurement signals to breathing of a man / woman, that is, breathing / woman synchronous means of the optical measurement signals.
  • 10. Digitalisierung des Herzschlagsignals, gemessen z. 10. digitization of the heartbeat signal measured z. B. mit EKG oder Puls, mittels ADC, um die optischen Meßsignale auf Herzschlag von Mann/Frau korrelieren zu können. B. ECG or pulse, by ADC in order to correlate the optical measurement signals to heart of man / woman.
  • 11. Für die Oximetrie am Föten zusätzlich Triggerung der Meßsignale auf kindliches EKG zum Puls Kind synchronen Mitteln der Daten. 11. For the oximetry on fetuses also triggering the measurement signals to childlike ECG to the pulse child synchronous transmitting the data.
  • 12. Signalauswertung (1. Ausführung): 12 signal evaluation (the first version):
    • a) Korrelieren der optischen Signale der verschiedenen Lichtwege bei gleichem Sender-Detektor-Abstand, a) correlating the optical signals of the different light paths with the same transmitter-detector distance,
    • b) Korrelieren der Daten mit Atmungs-/Herzaktivität, b) correlating the data with Respiratory / cardiac activity,
    • c) Bestimmung der jeweils mittleren optischen Gewebeparameter für die einzelnen Sender-Detektor- Abstände, c) determining the respective average optical tissue parameters for each transmitter-detector distances,
    • d) Bestimmung (z. B. aus Ultraschallbildern) der individuellen Geometrie der Patienten oder Mutter wie z. d) determining (z. B. from ultrasound images) of the individual geometry of the patient's mother or such. B. Schichtdicken der einzelnen Gewebekomponenten. B. thicknesses of the individual tissue components. Mit diesen Daten und der Kenntnis der ungefähren optischen Eigenschaften läßt sich z. With this information and the knowledge of the approximate optical properties, such leaves. B. mit FEM die Lichtausbreitung in oben beschriebener Meßanordnung näherungsweise berechnen. B. FEM with the propagation of light in the above-described measuring arrangement calculated approximately. Wenn diese bananenförmige Lichtausbreitungszonen für alle Sender-Detektor- Abstände einmal bekannt sind, können mit den Daten aus If this banana-shaped light propagation distances zones are known for all transmitters Detector once, can use the data from
    • (c) und diesem Model die optischen Eigenschaften des Meßobjektes quantitativ für die verschiedenen Tiefenlagen berechnet werden. (C) and this model the optical characteristics of the DUT are calculated quantitatively for the various depth positions.
    • e) Aus den in (d) bestimmten Absorptionskoeffizienten bei verschiedenen Wellenlängen wird die Oxigenierung für die verschiedenen Gewebeschichten berechnet. oxygenation for the various tissue layers is calculated e) From the determined in (d) absorption coefficients at various wavelengths.
    • f) Aus den bei verschiedenen Sender-Detektor-Abständen gemessenen Signalen wird derjenige Abstand von Sender- Detektor bestimmt, bei dem die fötale Pulsmodulation der Oxigenierung (dh ein Oxigenierungssignal, das phasensynchron zum kindlichen Herzschlag ist) gerade sichtbar wird. f) From the measured at different transmitter-detector separations signals one distance detector of the transmitter is determined at which the fetal pulse modulation of the oxygenation (ie, a Oxigenierungssignal, which is synchronized in phase to the fetal heart beat) is just visible. Die Signale bei kleineren Sender- Detektor-Abständen (als dieser so bestimmte Abstand) werden dann zur Bestimmung der mütterlichen optischen Gewebeeigenschaften und einer entsprechenden Korrektur des Gesamtsignals verwendet, um den fötalen Anteil des Oxigenierungssignals möglichst fehlerfrei bestimmen zu können. The signals at lower transmitter detector separations (as this distance thus determined) are then used to determine the maternal tissue optical properties and a corresponding correction of the total signal in order to determine the proportion of fetal Oxigenierungssignals error-free as possible.

Claims (13)

1. Vorrichtung zur nichtinvasiven optischen Erfassung der Sauerstoffversorgung eines Patienten mit einer Laser-Licht quelle ( 5 ), die einen Lichtstrahl ( 9 ) auf das Meßobjekt ( 10 ) richtet und einem Detektor ( 8 ), der das aus dem Meßobjekt ( 10 ) austretende Licht detektiert und einer Verarbeitungs schaltung ( 12 , 13 ) zuführt, bei der die Lichtquelle ( 5 ) Licht unterschiedlicher Wellenlängen ausstrahlen kann, bei der der Detektor ( 8 ) als Detektorarray mit mindestens drei Einzelde tektoren ausgebildet ist und bei der die Signale der Einzel detektoren derart verknüpft werden, daß das Sauerstoff-Sätti gungssignal des untersuchten Organs von den Störsignalen des darüber liegenden Gewebes getrennt wird. 1. An apparatus for noninvasive optical detection of the oxygenation of a patient with a laser light source (5), which directs a light beam (9) onto the object (10) and a detector (8), of the light emerging from the measurement object (10) light detected, and a processing circuit (12, 13) supplies, in which the light source can radiate (5) light of different wavelengths, wherein the detector (8) detectors of a detector array having at least three Einzelde is formed and in the detectors, the signals of the individual that the oxygen supply Saetti signal is separated of the organ being examined from the interference signals of the overlying tissue are linked in such a way.
2. Vorrichtung nach Anspruch 1, bei der ein Referenzstrahl ( 16 ) auf ein Meßphantom ( 15 ) gerichtet wird, dem ein weiterer Detektor ( 17 ) zugeordnet ist, wobei die Detektorausgangs signale in einer Auswerteeinheit ( 13 ) verglichen werden. 2. Device according to claim 1, wherein a reference beam (16) is directed to a measurement phantom (15), which is assigned a further detector (17), wherein the detector output signals are compared in an evaluation unit (13).
3. Vorrichtung nach Anspruch 1, bei der das Detektorarray li near ausgebildet ist. 3. The apparatus of claim 1, wherein the detector array is formed near li.
4. Vorrichtung nach Anspruch 1, bei der mehrere lineare De tektorarrays vorgesehen sind. 4. Device according to claim 1, provided with the plurality of linear De tektorarrays are.
5. Vorrichtung nach Anspruch 4, bei der die Detektorarrays im Winkel zueinander angeordnet sind. 5. Device according to claim 4, in which the detector arrays are arranged at an angle to each other.
6. Vorrichtung nach Anspruch 1, bei der die Einzeldetektoren auf einer beliebigen Fläche angeordnet sind. 6. The apparatus of claim 1, wherein said single detectors are arranged on any surface.
7. Vorrichtung nach einem der Ansprüche 1 bis 6, bei dem die Lichtsignale in der Intensität moduliert sind. 7. Device according to one of claims 1 to 6, wherein the light signals are modulated in intensity.
8. Vorrichtung nach einem der Ansprüche 1 bis 7, bei der die Messungen mit Körperfunktionen synchronisiert sind. 8. Device according to one of claims 1 to 7, in which the measurements are synchronized with bodily functions.
9. Vorrichtung nach einem der Ansprüche 1 bis 8, bei der die Lichtquelle ( 5 ) und/oder der Detektor ( 8 ) mit anderen Appli katoren kombiniert sind. 9. Device according to one of claims 1 to 8, wherein the indicators, the light source (5) and / or the detector (8) with other Appli are combined.
10. Verfahren zur Signalauswertung bei der Vorrichtung nach einem der Ansprüche 1 bis 9, bei dem für die einzelnen Sen der-Detektor-Abstände jeweils die mittleren optischen Gewebe parameter und daraus die Oxigenierung bestimmt werden. 10. A method for signal processing in the apparatus according to any one of claims 1 to 9, the detector distances each parameter the mean optical tissue and are determined therefrom, the oxygenation in the individual for Sen.
11. Verfahren nach Anspruch 10, bei dem die optischen Gewebe parameter bestimmt werden, indem auf der Basis von anatomi schen Schnittbildern der Lichtausbreitungsweg berechnet wird. 11. The method of claim 10, wherein said tissue optical parameters are determined by calculating on the basis of anatomical rule sectional images of the light path.
12. Verfahren nach Anspruch 10 zur Bestimmung des Sauer stoffstatus eines Fötus, bei dem aus den bei verschiedenen Sender-Detektor-Abständen gemessenen Signalen derjenige Ab stand bestimmt wird, bei dem die fötale Pulsmodulation des Oxigenierungssignals gerade sichtbar wird, wobei die Signale bei kleineren Abständen zur Korrektur des Einflusses des müt terlichen Gewebes verwendet werden. 12. The method according to claim 10 for the determination of the acid material status of a fetus, it is determined at the one from the measured at different transmitter-detector separations signals from stand, in which the fetal pulse modulation of the Oxigenierungssignals is just visible, the signals at smaller intervals are used for correcting the influence of the MüT terlichen tissue.
13. Verfahren nach Anspruch 10, bei dem die Signale der ver schiedenen Lichtwege bei gleichem Sender-Detektor-Abstand korreliert werden. 13. The method of claim 10, wherein the signals of the various light paths with the same transmitter-detector distance can be correlated.
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