EP3768157A1 - Vorrichtung und verfahren zur aufnahme und analyse von bildern der haut - Google Patents
Vorrichtung und verfahren zur aufnahme und analyse von bildern der hautInfo
- Publication number
- EP3768157A1 EP3768157A1 EP19713735.9A EP19713735A EP3768157A1 EP 3768157 A1 EP3768157 A1 EP 3768157A1 EP 19713735 A EP19713735 A EP 19713735A EP 3768157 A1 EP3768157 A1 EP 3768157A1
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- EP
- European Patent Office
- Prior art keywords
- skin
- color
- pulse
- data
- image
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
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Classifications
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/024—Detecting, measuring or recording pulse rate or heart rate
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- A61B5/0205—Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
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- A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
- A61B5/1032—Determining colour for diagnostic purposes
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- A61B5/441—Skin evaluation, e.g. for skin disorder diagnosis
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- A61B5/021—Measuring pressure in heart or blood vessels
- A61B5/02108—Measuring pressure in heart or blood vessels from analysis of pulse wave characteristics
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- A61B5/021—Measuring pressure in heart or blood vessels
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- A61B5/024—Detecting, measuring or recording pulse rate or heart rate
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- A61B5/024—Detecting, measuring or recording pulse rate or heart rate
- A61B5/02416—Detecting, measuring or recording pulse rate or heart rate using photoplethysmograph signals, e.g. generated by infrared radiation
- A61B5/02427—Details of sensor
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- A61B5/026—Measuring blood flow
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Definitions
- the present invention relates to an apparatus and method for the contactless recording and analysis of images of the skin of a living organism, in particular a human.
- a living organism in particular a human.
- the device and the method can also be used to use the data obtained in the context of a medical diagnosis and, in particular, early detection of diseases.
- Skin coloration refers to the color of the skin, which depends, among other things, on the pigmentation, the current blood circulation and the oxygen supply.
- diseases alter the skin color, as well as the time-constant circulation of blood vessels and tissues of a living organism.
- the supply by the pulse pressure wave is based on a principle of physical necessity and the respective structure.
- blood is pumped to the periphery.
- the arterial branches thus also bring the loaded blood into the upper layers of the skin. This happens with every beat.
- a moving image is a sequence of individual images and each individual image is a matrix of pixels, wherein a pixel has a plurality of data components or color components.
- each pixel consists of four so-called subpixels.
- Each subpixel is a light-sensitive surface covered with a color filter. These color filters typically pass the red, green or blue light. In many image data formats, the intensities of these subpixels are stored directly as red, green or blue values.
- Today's systems such as Tensiomed's arteriograph, are used to detect blood pressure and pulse wave velocity. This is to determine the vascular stiffness to detect vascular diseases.
- the augmentation index (Aix) provides information about the vascular tone (Vasolidation) of the small arteries and arterioles. The lower the Aix, the more the small arteries and arteries are dilated.
- a current boso system simultaneously measures blood pressure on more than one extremity. With the PAVK screening of the bosos ABI system, not only the blood pressure but also the pulse wave velocities are determined, recorded and processed for diagnostics. These two systems currently represent the gold standard in the medical application of noninvasive diagnostics of vascular diseases according to the manufacturer.
- WO 2014/072461 A1 a method and a device will be described for the image-based determination of vital data, in particular heart pulse and pulse wave.
- the procedure disclosed therein concentrates on a highly time-resolved analysis of a locally narrow area of the skin surface, above all, does not offer a possibility of a highly spatially resolved analysis of a large area of the skin surface.
- the pulse rate and the propagation of the pulse wave can already be determined and displayed today by means of Doppler sonography.
- This is a very localized method of examination in which ultrasound is emitted into the tissue.
- the ultrasound is reflected among other things on the blood cells.
- the reflected ultrasound frequency now depends on the speed of the blood cells and changes minimally with the speed of the blood cells. This effect is called Doppler effect.
- Doppler Sonography is expensive to buy and can only be used by trained medical staff.
- Another system based on the effect of variable skin coloration due to blood flow is plethysmography.
- light is irradiated into the tissue, typically on a finger, and the reflected light or light shining through the finger is analyzed.
- the reflected or the light shining through the finger shows a brightness fluctuation with the heart pulse.
- This method is very sensitive to extraneous light; therefore, a corresponding arrangement must be housed.
- the invention aims to provide an improved compared to known systems methodology and an improved device to improve the data in a berckenungslo sen optical measurement of the skin surface of a life to be examined the organism, in particular a human to obtain data about Farbver changes of the skin and from this conclusions to be able to pull.
- the device according to the invention and the method according to the invention in particular-based on recorded data of the skin color and its change-vital data of living beings, in particular of humans, can be detected.
- the device presented here and the method in particular also initially the heart pulse, this on the one hand on a spatially resolved the skin surface and time very accurately determine.
- the invention in particular also the intensity of the color change of the Hautko lorit with.
- the peculiarity of the invention on the one hand consists in the fact that the data for the cardiovascular system determined from the analysis of the skin color can be recorded spatially resolved.
- the particularly simple and easily implementable possibility of detecting the amount of different vital data shown simultaneously is particularly important with the invention. In order to highlight the usefulness of these data and the underlying procedures as well as the simultaneous collection of various data, diagnostic procedures made possible by the procedures are described.
- the differentiation to previous methods for analyzing a moving image with respect to the pulse is in particular that a spatially resolved measurement of the pulse wave (s) is made possible by means of tiles. Furthermore, the principle of this measurement is not limited to the use of light in the visible to the human eye range, but in particular in other color ranges applicable to e.g. in the infrared range.
- these enhancements across existing technologies allow for a deeper assessment of a human's cardiovascular system based on the data collected.
- the pulse wave transit time or pulse wave velocity can be determined locally on the body.
- a difference between a right and a left limb may, for example, show an occlusion of arteries.
- a difference between the Pulswel len beau between arms and legs can point to already beginning closures, so that timely countermeasures can be taken.
- data on the course of arteries and veins can be determined, with further analysis also statements on the states of internal organs are possible.
- the pulse wave which passes through the arterial bloodstream many times faster than the blood itself, causes a change in the brightness of the skin surface. With the human eye as a visual diagnostic procedure, this change is not visible. However, this change can be detected and measured with a camera with a special resolution and a special frame or frame rate per second. The measurement of heart rate as a frequency, is possible at any suitable body site. The more powerful the camera is, the more diagnostic options there are.
- the pulse can be measured as a simple diagnostic procedure. Depending on the frame rate and its increase, the accuracy of the pulse measurement is improved. With industrial cameras, 1000 frames per second and more are possible. Thus, it can be measured with medical accuracy. But even with a far lower ren frame rate, it is possible to measure a pulse and derived therefrom, for example. to detect peripheral arterial occlusive disease PAD and diabetic foot syndrome (DFS).
- PAD peripheral arterial occlusive disease
- DFS diabetic foot syndrome
- pulse wave velocities are measurable.
- the so-measured pulse wave velocities are by comparison another diagnostic means.
- the use of a camera which picks up in the visible light or in the near infrared range is advantageous.
- the parameters of the spatial resolution and the temporal resolution or the repetition frequency are important for the method and should advantageously correspond to the best possibilities of the state of the art.
- a minimum image repetition rate of 300 is required. Since in most cases not such a high pulse rate is present, cameras with lower frame rates can be used.
- the requirements for the local resolution are related to the application. If only individual areas of the skin, e.g. As part of a medical examination, resolutions in the HD range are sufficient, ie 1920 x 1080 pixels. However, if the entire body to be detected, correspondingly higher resolutions are needed.
- HD resolutions and corresponding optics are used, not only can a large-scale analysis be carried out, but also an analysis of very small areas is possible.
- the process does not have to be limited to the analysis of a single small job, but it can also cover several such small jobs in one area at the same time. This is for example advantageous in the detection of malignant liver spots or the evaluation of microangiopathies.
- a zoom setting tracks the person to be observed and therefore picks up the entire person.
- the second zoom setting is on a ne skin surface and is moved on the basis of the determined movements of the first zoom setting.
- HD resolutions are needed to determine the vital data, but it is structurally advantageous to use higher resolutions in the case of weather.
- the invention presented here makes it possible to better detect changes in the skin even of very small areas by using selected cameras and the use of logics to detect color changes.
- the use of moving images can make further skin changes visible.
- so-called Feuermale by an altered circulation.
- the true size sol cher Feuermale due to the differences in the blood flow can be identified ge.
- the invention presented here can replace the above-mentioned method of Doppler sonography for the near-surface tissue sections and extends the method to a large area of investigation.
- the apparatus equipment of the invention presented here is much cheaper and the invention can also be used by not trained to a scale staff, as is neces sary for the implementation of Doppler sonography.
- non-contact diagnostics for example, no disposable materials for hy gienisches working needed and thus disposal of such disposable materials after use superfluous. The sterilization of reusable materials is eliminated. The mobile diagnostic telemetry / spaced measurement gestat tet a barrier-free work. 4. ⁇ Analysis of the human cardiovascular system
- PAOD peripheral arterial occlusive diseases
- the described invention analyzes moving images of a skin surface and detects the pulsation of the blood in the tissue.
- the analysis of the pulsation occurs in comparison to non-diseased parts, these are usually the larger blood vessels. Larger blood vessels also lose less in their visible pulsation due to a possible illness and can therefore be used for the comparison.
- the pulse can be determined at different locations, in particular simultaneously. Since a high temporal resolution is possible, especially at 300 fps or more, the pulse can be imaged as a wave of change in the intensity of a color at each examined point of the surface to be examined.
- the wave at a perfused or non-diseased point shows a wave having local minima and maxima in time with the cardiac pulse.
- the temporal difference between two consecutive maxima or minima gives the RR interval and the reciprocal is the frequency of the heart pulse.
- the pulse wave variability can also be determined. This can be derived, for example, from the standard deviation to the mean value of the specific frequencies of the cardiac pulse.
- the frequency of the heart pulse varies due to the activities of the body. At rest, breathing is therefore an essential factor. If the ascertained frequencies of the cardiac pulse are displayed in a graph over time, then again a wave with local minima and maxima results, these now appear in the rhythm of the respiration and an analysis of the local minima and maxima yields the respiratory rate.
- a temporal offset of the waves with each other can be determined. This temporal offset is the pulse wave transit time between the points, which can also be verified.
- the distance between the at least two points can also be determined. This can be done approximately by measuring typical proportions on the body, which then serve as a benchmark. These typical pro portions are, for example, the distance between the eyes to each other. For a more precise He generation of a scale marks on the skin with a well-th distance from each other can be attached. If a scale is known and thus also the distance between the at least two points, then the pulse wave velocity can also be determined from the pulse wave transit time. The pulse wave velocity can advantageously be determined for each point of the surface to be examined. This is particularly advantageous because the pulse wave velocity depends essentially on two parameters: For egg nem this is the diameter of the arteries and on the other hand, the rigidity of the arterial walls.
- typical pulse wave velocities can be taken from a table of age and artery and are comparable to the measured velocity.
- Typical pulse wave velocities for, for example, the femoral artery lie in young humans at 8-9 m / s.
- Excessive pulse wave velocities are a well-known indicator of a prevailing vascular stiffness. Local changes in pulse wave velocities, such as side differences, may indicate stenosis.
- the measurement of pulse wave arrival times, based on each cardiac action, on each individual region of skin area reflect the cardiovascular system, such as the blood pressure individual values on the arms and legs, the blood pressure side difference (eg, type of subclavian stenosis), pulse, pulse pressure, arterial Pulse contour, venous pressure, venous pulse contour and indications of possible cardiac arrhythmias at critical values.
- POD Peripheral arterial disease
- DFS Dia betetic foot syndrome
- the macroangiopathy underlying PAOD can be treated by means of revascularization measures.
- macroangiopathy of DFS there is no causal therapy option. In Germany, approx.
- the pulse in the veins is a rarely used factor for assessing the cardiovascular system.
- the heart aspirates blood from the veins during a pulse through the atria to push it into the arteries in a second phase through the chambers.
- Arterial insufficiency is caused by constrictions (atherosclerosis) in the arteries and leads to a stiffening of the arterial walls, which in turn leads to an increase in the pulse wave velocity compared to a healthy state.
- Venous insufficiency is caused by persistent high blood pressure in the veins (normal value 20-30 mmHg, high pressure values up to 60-90 mmHg).
- Reasons for this may be a venous drainage obstruction or a defect in the ve nösen flaps.
- the veins are stretched.
- a first and well-known sign of this is varicose veins.
- an increased venous pressure leads to the destruction of the venous valves, resulting in a vicious circle.
- Recognition is via the visible change in the size of the veins and in their change in intensity during a pulse. The more dilated the veins are, the weaker the intensity change compared to the healthy state.
- the invention achieves the object in the arterial area of an "arteriosclerosis lim ders.”
- the invention makes constrictions and closures visible in the venous return flow
- the invention makes the lymphatic flow visible the neural trophic condition, such as neuropathy, diabetic microangiopathy, sweat secretion
- the invention measures lesions such as e.g. malignant and benign nevi, systemic skin diseases, internal diseases, e.g. Jaundice, or tissue disorders such as cellulitis.
- the invention can also scent infections, for example. Detect inflammation of the mucous membranes in the mouth, nose, intestine or genital area.
- Detection is based on two backgrounds.
- the determined temporal intensity change of the skin color is softened under skin changes in contrast to the surrounding tissue, whereby the skin changes can be detected. Inflammations usually show a stronger change in intensity than in the environment.
- the algorithms presented here can be applied not only in the temporal dimension, but also in the spatial dimension. In this way, the smallest color changes along a path on the skin can be determined and thus also a surface change of the color on the skin surface can be made visible.
- a combination of spatial and temporal measurement of the change in the color intensity of the skin color can give indications of sites where increased sweat secretion occurs. These areas may give an indication of inflammation.
- the Head's zones are areas of the skin that were connected to internal organs during emby- ronal growth and are still connected via the autonomic nervous system in the adult state.
- a damaged organ emits a pain stimulus, which is not directly felt on the organ, but in the appropriate zone.
- This stimulus transfer is called the viscerocutaneous reflex.
- pain on the right side of the body or in the left arm also indicates problems with the heart.
- These transfers of the pain stimuli to the skin surface have the result that pain-typical see reactions, such as a sweat and / or Temperatur Masse tion.
- the invention can recognize a change from a normal sweat education education and thus a hint of a problem with an organ lie.
- a previously performed manually diagnostic method such as the Thermodiagnostik Barral, so the invention can be carried out by means of an automated system, so that even physicians who do not have the necessary thermal sensitivity can use this diagnostic method.
- An application based on an analysis of moving images to detect a skin lesion is the precise delineation of a fire mouth (Nae vus flammeus). In such a Feuermal the blood circulation is changed to the unchanged tissue.
- An analysis of the blood supply provides the exact shape and spread of a Feuermals, which is advantageous in planning and execution corre sponding cosmetic operations.
- ocular diagnostics or iris diagnostics it is assumed that the iris changes its life through material, "informatory" and psychological environmental influences, food, lifestyle, diseases, their therapy, etc., by storing color pigments or locally compacting their fibers.
- a color intensity change of the iris can be made locally resolved.
- the temporally resolved intensity changes tion shows the cardiac pulse and its recognizability on the iris. Both information can be analyzed in the context of iris diagnostics.
- Kneipp therapy can be found at s.g. Hydrotherapies their application. At this time, the body becomes cold water e.g. exposed by treading water. This is to promote arterial perfusion and promote venous return, e.g. To alleviate or prevent varicose veins.
- solutions are presented both to detect arterial perfusion and to detect venous return. A use before and after a Kneipp therapy can therefore provide information about the effectiveness. In addition, the size of varicose veins and their change can be detected.
- the invention makes it possible to determine the blood circulation of the tissue from a distance by means of spaced measurement.
- the automated monitoring and evaluation of the changeable skin color is thus a new process not only for medicine. Rather, it should enable people to recognize diseases such as PAD or DFS at an early stage. Therefore, the invention may be preventive, such as e.g. a thermometer or a blood pressure measuring system, in the house hold by patients or even as a healthy recognized people use to recognize the state of vulnerable skin and tissue areas.
- the measurement of the pulse at a distance is an application in itself and can be used in a variety of areas.
- the invention determines the heart rate from heartbeat to heartbeat and can also measure the respiratory rate.
- Quality feedback of a service such as Recognition of the condition before and after a visit to a recreational facility
- the invention makes use of a special device and a method for making visible and quantifying the slightest damage or color change within an image, a moving image recording, a time-lapse recording or an image sequence.
- color is to be understood in particular as being common in the following.
- Imagewise recordable by a technical apparatus are today electromagnetic waves or colors with wavelengths from the millimeter range (terrahertz radiation) on the infrared range, the range of visible light, the UV range up to the picometer range (X-radiation).
- the pulsating change in the skin surface can be recognized by the brightness change caused by filling the arteries with blood.
- the infrared range in particular in the red to near infrared range, between 0.7 and 3 dm wavelength, the light can penetrate particularly deep (1 -3 mm) into the tissue.
- the infrared light can be used to represent arteries and veins. It is exploited under different absorption behavior of hemoglobin depending on the oxygen saturation.
- Non-oxygen-saturated hemoglobin has an absorption channel at 760 nm, while oxygen-saturated hemoglobin at 950 nm is particularly light-absorbing. If an acquisition is carried out in these wavelength ranges, the arterial and in comparison of the venous pulse can be summarized and the course of the respective arteries or veins can be represented.
- a camera with a wide sensitivity in the infrared range can be selected.
- a camera that also covers the range of 3.5 - 15 Dm can additionally detect the heat radiation and thus also detect the temperature and its distribution on the skin.
- the invention uses a special device and a method to detect the fürlau fende pulse wave.
- a special device and a method to detect the effetlau fende pulse wave are moving pictures of the Surface of the skin of a living organism, such as a human ge uses.
- the pulse can be measured as a simple diagnostic procedure. Depending on the frame rate and its increase, the accuracy of the pulse measurement is improved. With industrial cameras 1000 frames per second and more are possible. Thus, it can be measured with medical accuracy. But even with a much lower frame rate, it is possible to measure a heart rate and determine a peripheral arterial occlusive disease PAD and diabetic foot syndrome (DFS).
- FDS peripheral arterial occlusive disease PAD and diabetic foot syndrome
- a corresponding and depending on the application constructed camera ver be used, which measures the pulsating change of the skin surface, which is generated by the pulse wave, starting from the heartbeat.
- the total surface or parts of the skin surface can be measured.
- the change in the brightness of individual color components or combinations of color components is determined on the respective measured skin section. If one uses the pulse measurement on different body parts and limbs simultaneously, pulse wave velocities can be measured. In this section, it is shown how a moving picture of an organism eg of a human, the pulse wave can be determined from the heart.
- the pulse wave For the evaluation of the organism, it is advantageous to determine the pulse wave at one or more fixed points on the body surface. For further analysis, the highest possible temporal resolution is advantageous.
- the detection of multiple sites on the body surface at the same time represents in particular a novelty and allows far-reaching analyzes, which are listed in Chapter 6.
- the invention can measure individual areas of the skin of a human color and time Lich resolved and compare. However, it can also measure skin cells in a time-resolved manner based on a change in color and compare them to any other skin cell discoloration in a time-resolved manner on the body.
- the detection of the pulse wave from a moving picture takes place in the following steps:
- Well-known algorithms such as those provided, for example, in the OpenCV library, are suitable for the recognition of a human being in a picture today. These algorithms can be set to suit a human in the image, or individual body sites, such as a human body. can recognize the face.
- the face is first found. Based on the eye position and the total size of the face in the image, the position of the forehead can be found based on fixed proportions.
- a camera can be used, which must be driven close to the body for this resolution.
- the image to be captured on the skin can be marked by markings on the skin. These may e.g. in the form of crosses, which can be recognized by known algorithms.
- the area on the skin can also be tracked. Several points, at least three, are tracked. If the positions of the tracked points in the image change, the section of the skin to be examined has also shifted in the image. Now the image section, which represents the skin section to be examined, must be changed in position, size and shape, so that the relations to the traced points remain the same. This means that if two points located opposite each other on two different sides of the skin surface to be examined are closer to each other in the image, the area along the connecting line of the two points must be compressed to the same extent.
- a digitally recorded image consists of a multiplicity of pixels or pixels.
- the section of skin to be examined extends over part of these points.
- the color in the section of skin to be examined is quantified by the mean of the color. As a rule, the skin section to be examined does not cover an integer multiple of pixels.
- the mean value of color over a section of the skin A results from all pixels p of an image as follows:
- A the area of the skin portion A
- intermediate values reflect the area fraction of the pixel in A.
- the data important for the analysis are obtained directly from the color information.
- the brightness of the skin section to be examined can be determined and normalized to the image detail.
- a more meaningful information is obtained when not only a total brightness is determined, but is distinguished by individual colors.
- the color content once found in a human being can usually be used by other people as well.
- the aim of the analysis of the change in color in the observed section of the skin is to represent the slight variations in color with the heart pulse in relation to the color, so that influences due to movement of the person to be examined or "bad" light are calculated out.
- higher frequencies are removed by digital filters. These may e.g. Be lowpass filter or running average.
- the filters must be adjusted depending on the frame rate of the camera in order to weaken higher frequencies in the signal. Too weak attenuation prevents the attenuation of the oscillations due to the power network and too much attenuation attenuates the signal to much and less detail, e.g. the reflection wave, are recognizable. In particular, a weakening of the frequencies greater than 10 Hz is advantageous. This results in a noise-free signal.
- the (output) signal is filtered a second time by means of low-pass filter.
- a suitable filter for this purpose is eg a Kolmogorov-Zurbenko filter. This filter is worth several times the running average.
- the setting is again based on the frame rate of the camera, so that now even smaller frequencies are attenuated
- the filtered signal should have no vibrations with the heart rate.
- a weakening from lower frequencies causes sudden changes over a long period of time to have an effect, and attenuation from higher frequencies will also filter possible changes due to cardiac pulses become.
- a weakening of the frequencies greater than 0.5 Hz before geous. The result is the signal background.
- the adjusted signal can be examined for local minima and maxima.
- the data at the time and the data on the intensity of the minima, or maxima are known from such a signal.
- the time interval between two successive minima or maxima is just the time taken by a heart pulse and is referred to as the RR interval.
- the RR interval can also be specified as a heart pulse, which is 60s / RR, where RR is the RR interval in seconds.
- the intensity of the adjusted signal gives two pieces of information. On the one hand, it shows how well the affected area of skin is perfused, so a non-variable signal indicates whether there is angiopathy. If a variable signal is recognizable, on the other hand the intensity can be examined from pulse to pulse.
- the course of intensity of local minima and maxima follow respiration. Upon inhalation, the blood pressure and thus the filling of the arteries increase, the intensity of the signal decreases and the intensities of the minima and maxima are at a smaller distance from one another. When exhaling, the effect is reversed. From the sequence of the distances of the intensities of successive minima and maxima, a wave-shaped signal can in turn be derived. The local minima and maxima of this signal give the times of inhalation and exhalation.
- the frequency of the respiration can also be determined in another way from the purified signal.
- the heart rate increases and when exhaled it falls again.
- the determination of the heart rate can be made from beat to beat, thus the course of the heart rate can also be displayed in time. This in turn results in a wave-shaped signal and the time intervals of the local minima to the local maxima give the times of inhalation and exhalation.
- the aim of an analysis of a single image is to determine the smallest color deviations from one skin position to another. Examples of color deviations are liver spots and other skin changes, see chapter 4.2. People has a variety of liver spots, but most liver spots are not visible to the human eye. The analysis of an image allows to visualize these non-recognizable liver spots. A further evaluation determines the sizes and the spatial relation of the spots.
- the algorithm for detecting these lesions is similar to the previous algorithm for analyzing moving pictures.
- a point on the skin surface is tracked from image to image.
- Corresponding pixels are used at a point on the skin.
- the points along a straight line are used. These also show a color change, but this time not along a time axis, but along a spatial axis.
- the obtained intensities along the line are processed as well as in the previous algorithm for analyzing moving pictures.
- An improvement in the color information can be achieved by using not just a single image, but several in a short time sequence recorded images, eg a section of a video recording.
- the movement of the imaged body region is determined, as in the algorithm for analyzing motion pictures, and the images are correspondingly moved against each other and superimposed. From the superimposed images, a mean value of the color for each point is generated at the points to be examined. This reduces the noise of the color and increases the resolution of the intensity change.
- the change in intensity is not only determined along a straight line, but along a large number of parallel straight lines so that the entire surface of a skin surface to be examined is covered.
- the ascertained intensity changes can now in turn be made in a two-dimensional view, e.g. as a heatmap, over an image of the skin section to be examined. It is the individual skin changes and clearly distinguishable from the ground surface to recognize.
- the data for creating the heatmap can be applied to known algorithms for blob detection. These algorithms can be designed so that the area of the skin changes, their center point, their average brightness and their shape descriptors, such as circularity, can be determined.
- the areal and positional data are determined in units of pixels or pixels $ ⁇ 2 $ and can be converted to SI units via a scale.
- typical distances such as the distance of the eyes to each other, determined and used as a scale under Ver use of typical lengths, or advantageously Mar markings are applied at a known distance on the skin surface and used their distance as a yardstick.
- the analysis of a single image receives a medical statement when multiple images of the same skin site are compared.
- By comparing the potential growth of a liver spot can be detected to remove the sen, before possibly developing a skin cancer.
- an image of a body site on which "suspicious" liver spots are present is recorded at regular intervals, and the image is analyzed for changes in brightness or color.
- the interval between two images can be between a few days, weekly, and weeks vary to half a year.
- the procedures listed in the previous section determine the size and position of the visible and invisible liver spots to the human eye.
- the aim of the analysis of two temporally successive images is to detect changes in size of the liver spots.
- the particular positions and sizes of the (medically consistent) liver spots in the image are identical, and any observed size difference is an indication of an endangered liver spot.
- the second picture shows an area of the skin surface rotated to the first image.
- the second image shows a larger or smaller area of the skin surface than the first image.
- the second image shows an area tilted spatially to the first image.
- the second picture shows new liver spots compared to the first picture.
- the second picture shows in comparison to the first picture changed size of liver spots.
- the sizes of the individual lesions in both images will be determined. Since the two images are aligned with each other, the size differences of individual skin lesions can be recognized, or even new skin changes can be detected. The changes can subsequently be applied via a recording of the skin area to be examined as a semi-overlay overlay and thus a simple assignment of hazardous skin changes is possible.
- the invention can measure individual areas of the skin of a human color and time Lich resolved and compare. However, it can also measure skin cells in a time-resolved manner based on a change in color and compare them to any other skin cell discoloration in a time-resolved manner on the body.
- the invention measures the pulse wave arrival time at each body site of the skin surface, for example of a human. From the multitude of possible data For the first time, significant conclusions for medical diagnostics can be measured without contact. Incoming pulse waves in an overall image of a human, reflect the circulation on each point of the human body, temporally and spatially resolved, again.
- tissue and vessel image that, depending on the penetration depth of the light, provides information about the measuring point and the measuring depth. Depending on the available computing power, this information can be displayed in a 2- or 3-dimensional image of the vessels and tissue.
- the areas that are tracked and used for analysis are also called chalices.
- such tiles are distributed over the skin in the image, so that the entire area is completely covered. Therefore, for the shape of the tiles are the area-wide forms triangle, square and six corners.
- the tiles may also overlap each other and have other shapes.
- the data found are 2- or 3-dimensional shape and difficult for the user to classify. Therefore, the following algorithms are required for the presentation or classification and their presentation of the vital data found: • Illustration of the pulsation of the arteries in relation to each other.
- a display displaying one-dimensional time-varying data, e.g. the heart rate, the respiratory rate, the pulse wave velocity, the temporal offset of the pulsation between two or more points, on a view and provides a classification.
- one-dimensional time-varying data e.g. the heart rate, the respiratory rate, the pulse wave velocity, the temporal offset of the pulsation between two or more points
- Hautoberflä surface or is examined a complete page of a person to be examined. If several cameras are used simultaneously, the entire surface of the body can also be examined. The measurement can evaluate and display the data live or virtually live. However, if a large area of the skin surface is examined, recording and later analysis are advantageous.
- the entire surface can be detected at once. This requires a camera with a much higher resolution with the same spatial resolution as in the second class.
- the skin surface can be examined section by section. If the area is examined section by section, each section has a different temporal assignment, but in comparison a higher spatial and temporal resolution can be made possible, whereby the costs for the system are lower.
- the advantage of recording the entire surface with only one setting is the easier handling of the recording and the use of only one camera, without further equipment.
- each section is advantageously recorded and then analyzed.
- the section examination can be performed in different complexity as follows.
- the camera can be moved manually to capture the desired sections. Stands are set up and aligned for each section. Then, the camera is manually moved from tripod to tripod, recording a motion picture sequence.
- the plurality of tripods can, for example, be realized by a vertical board with recesses for each section to be examined for the camera.
- the mechanical movement is advantageous. This can be realized, for example, as in an inkjet printer or a melt layer (FDM) 3D printer
- the camera is mounted on a linkage consisting of at least two sliding rods. Along this sliding rods, the camera can be by means of a BEWE handling unit, this may be, for example, belts or threaded rods, who moved the.
- the at least two slide rods are in turn mounted on at least two slide rods perpendicular to the first at least two slide rods.
- the first two slide bars together with the movement unit and camera can be moved in turn with another movement unit. This allows precise positioning on a surface.
- the movement of the person to be examined can, for example, be carried out analogously to examination in an MRI apparatus.
- the person to be examined is fixed on a movable couch and recorded from above by means of a camera.
- the lounger now moves step by step and thus brings in sections always another skin area in the image of the camera.
- AOI Absolute Of Interest
- An angiopathy is indicated by the absence of a pulse in a region of the tissue.
- a semi-transparent overlay which is placed over the images of the moving image, timed so that the time point of the images of the moving image at the times of the determined pulse waves fit.
- the color or the transparency of the overlay in the areas of the tiles results from the currently determined intensity of the color change.
- the overlay over a pulsating artery discolors or changes its transparency so in time with the heart pulse. So that the coloring of the overlay can be made uniform, the intensity variation of each tile must be matched with the intensity variations of the other tile who the. In addition, changes in brightness that affect the entire area must be detected and calculated out.
- the average height of the local minima and maxima of the intensity fluctuations of each tile at the currently displayed time are determined. From the values of the minima an average is formed, advantageously this is a running average. For the maxima, the procedure is analogous. Based on the respective average of the current local minima and maxima, the intensity fluctuations are normalized and scaled with a color scale or a transparency scale for the overlay. The scaled current value of each tile colors the overlay at the tile's current position over the face of the tile.
- Angiopathy is detected by analyzing the normalized intensity fluctuations of the individual tiles. Since these were not normalized for themselves, but for all tiles together the normalized intensity indicates how strong the blood circulation is. The normalization may preferably take place as a percentage of the running average values of the minima and maxima. Thus, the value of normalized intensity variation indicates the degree of perfusion. Tiles that have, for example, an average blood flow of less than 25% over the entire measurement can be marked in the overlay in color or by a transparency. The tissue below these areas of the skin may be suffering from angiopathy and should be further analyzed as part of a more detailed medical examination.
- Pulse wave speed The pulse wave velocity can be determined from the knowledge of the pulse wave transit time between two points and their distance.
- the pulse wave transit time becomes visible in the case of a slow-motion representation of the pulse, which is displayed by means of an overlay, as shown in the preceding section.
- the perfused area spreads concentrically within the ejection phase of the pulse. The circulation disappears again concentrically.
- the pulse wave transit time is detected by plotting the intensity variation from the central tile and another of a tile in the concentric propagation area as a graph. These graphs are temporally shifted from each other.
- the time offset is the pulse wave transit time.
- the determination of the pulse wave transit time can be automated for the intensity fluctuations of each individual tile. For this purpose, each intensity fluctuation is examined for local minima and maxima and their times are found and stored. If, for example, a minimum is found in a curve, then the pulse wave of the previous beat has already passed through and all previous maxima belong to one beat. The values of the previous maxima are now analyzed and then rejected to allow further measurement. The earliest maximum is found.
- the associated tile is at the starting point of the pulse wave.
- the temporal difference of the maxima to each other tile determines the pulse wave transit time from the start tile to the respective tiles.
- the location of each tile, and therefore the distance to any other tile must be known in SI units. This is achieved by recognizing a scale in the image, this can e.g. the distance from prominent body features, e.g. the eyes, his or it marks are applied to the skin at a known distance.
- Arrhythmias are detectable by missing or too many heartbeats within normal heart rate. Since the course of the heart pulse also within a Heart pulse is represented by the color intensity fluctuation, the average heart rate can be determined. Since the heart rate can also be determined from beat to beat, an arrhythmia can be detected by multiplying the heart rate (additional beats) or reducing the frequency (missing beats).
- This feature is not planar and therefore does not necessarily require a surface evaluation. However, due to optical influences also errors in the data can occur, the multiple measurement and examination of the pulse on several tiles is useful to avoid misinterpretation.
- the veins can be displayed in the same way. It should be noted that the veins can not be made visible with a conventional camera. As already described in Chapter 5, a camera in the infrared range and with infrared illumination is necessary to depict the veins.
- an overlay can be colored so that only the pulse is displayed in selected artefacts.
- the choice of artery or vein is made by choosing or limiting a maximum intensity. An example of this is the visual Chung of the two main arteries, which lead into the head, and their differences in the pulse.
- FIG. 2 A display to illustrate the data obtained and their analysis by the user or by a trained medical professional must fol folloWing features, in Figure 2 a corresponding mögli surface shape is shown; the reference numbers in the parentheses refer to the reference numerals in the figure:
- Markings for the events on the timeline the size of the markings representing the time length and the color filling or stamping of the filling indicating different phenomena (2-10);
- a measurement point can be selected (2-5), eg on a "suspect" point, to show the course of the measured data (2-4) at this point
- known video playback tools (2-8) can also provide motion picture playback, in particular a slow-motion function, allowing the selection of a fixed time or the timing of the playback in that the corresponding real image is displayed in the display field (2-3), that the display of the current value (2-6) indicates the value at the current time, that in the pie chart (2-13) those selected (see below ) Data is displayed and that the two-dimensional data is displayed as an overlay (2-1 1) at the selected time.
- the overlay (2-1 1) displays the current value of each tile at the currently selected time by encoding the values in color or transparency, and this encoding fills the area of the tile.
- the overlay can also be set so that the individual tiles can be marked, eg by a border.
- the amount of data must be reduced in order to gain an understanding.
- the setting of the data to be displayed is made possible by selecting (2-12) the examination method and selecting the data (2-14) to be displayed.
- the selection changes the display of data in the pie chart (2-13).
- a pie chart consists of concentrated circles on which markings are applied, which mark a value depending on the radius.
- the pie chart is divided into two to indicate different values for both body halves.
- the value of a date results from the radial position of the mark on the corre sponding circle.
- a value which is distinguished by a healthy condition of the body is close to the horizontal through the center.
- a determined value which indicates a non-healthy condition, causes the marking to go below or above the horizontal. For example.
- a heartbeat of 60 beats per minute at rest a value that distinguishes a healthy body. A higher value shifts the marker up, a lower one moves it down. All vital data of the body are related to each other. In the example of the pulse this means that a pulse rate of 60 beats per minute has a respiratory rate of 20-30 times per minute. If this is not measured, then the mark on the breathing is not horizontal. However, the optimal range of respiration depends on the heart rate. If the heart rate is increased, for example, to 120 beats per minute, then a corresponding value for a healthy respiratory rate is correspondingly higher and is between 50-70 times per minute.
- a timeline (2-9) is available. It shows (2-7) marks (2-19) next to the current time position, which indicate irregularities.
- markers on the timeline and in the other display elements ((2-3) and (2-4)) used to mark different types of abnormalities.
- a marking within the pictorial display of the two-dimensional data (2-3) and the graphic data (2-4) is also possible.
- a plane (2-16) through the virtual body (2-1) and / or the image Liche display of the two-dimensional data (2-3) are placed.
- Selection tools (2-15) allow you to adjust the position and orientation of the plane (2-16).
- This plane cuts the raw data in half and allows the determination of resulting data in the two halves separately to examine the halves for differences. An adjustment therefore also leads to a change in the data which is compared in the pie chart (2-13) and which are compared in the display (2-6).
- a comparison of selected data (using (2-14)) can also be used as an indicator on a scale (2-17).
- the position of the indicator indicates on which side the data obtained differs to a healthy state and what the degree of differentiation is.
- An example of this is the pulse wave transit time in the face. Due to the two main veins, which lead into the head, both sides of the head are supplied differently Lich, the length of the arteries is different to the heart, it results in a different pulse transit time. The difference in the pulse wave transit time from the right to the left half of the head can be shown.
- the scale is formed, for example, as a color marking from red to green to red, with green representing a good and red a bad condition. The green mark is not central in the case of the pulse wave transit time, but shifted to the right due to differences in the length of the main arteries.
- the indicator relatively indicates the determined transit time difference.
- a shift of the indicator from the green area may indicate occlusive disease in the major arteries, with a shift to the right to a closure in the right aorta and a shift to the left to a closure in the left main artery.
- Figure 1 shows an example record of the intensity changes of the color in different tiles.
- Reference numeral 1 -1 shows Gra phen of several tiles, which have minima and maxima in time with the heart pulse.
- Reference numeral 1 -2 shows a graph of a selected tile.
- Reference numeral 1-3 shows edges in the graph due to a reflection wave due to the pulse wave.
- FIG. 2 shows an exemplary representation of a graphical user interface for the analysis of evaluated data.
- the graphical interface consists of a variety of settings that change the appearance.
- (2-2) selects the body region to be displayed in a representation of the entire detected body region (2-1).
- (2-5) selects a position at which time histories of one-dimensional data are extracted to represent them in a history (2-4) and as a value (2-6).
- the type of time history of one-dimensional data is determined by the choice of a method of analysis (2-12) and by the choice of a data type (2-14).
- the data is also presented in a pie chart (2-13) in such a way that at a glance the physical condition becomes recognizable at the current time.
- the time to be displayed (2-7) and / or moving picture display (2-8) can also be controlled.
- the data on the selected or current position in the playback will be overlayed (2-1 1) Image placed at time (2-3).
- Detected abnormalities are shown as marks (2-10) both in the course of the one-dimensional data (2-4), in the overlay (2-1 1), and on a timeline (2-9).
- a tool for further analysis can also be installed. Medically interesting is the comparison of two body parts relative to each other, this is made possible by a plane (2-16), which can be arbitrarily chosen (2-15).
- a comparison of the data of the two sides to each other can also be illustrated by a scale with indicator (2-17)
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Abstract
Description
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DE102018002268 | 2018-03-20 | ||
PCT/EP2019/056928 WO2019180065A1 (de) | 2018-03-20 | 2019-03-20 | Vorrichtung und verfahren zur aufnahme und analyse von bildern der haut |
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EP3768157A1 true EP3768157A1 (de) | 2021-01-27 |
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EP19713735.9A Withdrawn EP3768157A1 (de) | 2018-03-20 | 2019-03-20 | Vorrichtung und verfahren zur aufnahme und analyse von bildern der haut |
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US (1) | US12011250B2 (de) |
EP (1) | EP3768157A1 (de) |
CN (1) | CN112218576A (de) |
WO (1) | WO2019180065A1 (de) |
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US10667723B2 (en) | 2016-02-19 | 2020-06-02 | Covidien Lp | Systems and methods for video-based monitoring of vital signs |
CA3079625C (en) * | 2017-10-24 | 2023-12-12 | Nuralogix Corporation | System and method for camera-based stress determination |
WO2019094893A1 (en) | 2017-11-13 | 2019-05-16 | Covidien Lp | Systems and methods for video-based monitoring of a patient |
CA3086527A1 (en) | 2018-01-08 | 2019-07-11 | Covidien Lp | Systems and methods for video-based non-contact tidal volume monitoring |
US11547313B2 (en) | 2018-06-15 | 2023-01-10 | Covidien Lp | Systems and methods for video-based patient monitoring during surgery |
EP3833241A1 (de) | 2018-08-09 | 2021-06-16 | Covidien LP | Videobasierte patientenüberwachungssysteme und zugehörige verfahren zur detektion und überwachung der atmung |
US11617520B2 (en) | 2018-12-14 | 2023-04-04 | Covidien Lp | Depth sensing visualization modes for non-contact monitoring |
US11315275B2 (en) | 2019-01-28 | 2022-04-26 | Covidien Lp | Edge handling methods for associated depth sensing camera devices, systems, and methods |
WO2021084352A1 (en) * | 2019-10-31 | 2021-05-06 | Aarca Research Inc. | Non-invasive non-contact system and method for evaluating primary and secondary hypertension conditions using thermal imaging |
US11484208B2 (en) | 2020-01-31 | 2022-11-01 | Covidien Lp | Attached sensor activation of additionally-streamed physiological parameters from non-contact monitoring systems and associated devices, systems, and methods |
CN112617781A (zh) * | 2020-12-31 | 2021-04-09 | 暨南大学 | 一种远程动态新生儿黄疸血氧脉搏检测系统和方法 |
CN115153451B (zh) * | 2022-08-18 | 2023-03-21 | 重庆诺思达医疗器械有限公司 | 一种基于汗印成像的汗量检测方法 |
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US8360986B2 (en) * | 2006-06-30 | 2013-01-29 | University Of Louisville Research Foundation, Inc. | Non-contact and passive measurement of arterial pulse through thermal IR imaging, and analysis of thermal IR imagery |
WO2014072461A1 (de) | 2012-11-11 | 2014-05-15 | Grönemeyer Medical GmbH & Co. KG | Verfahren und vorrichtung zur bestimmung von vitalparametern |
WO2014136310A1 (ja) * | 2013-03-08 | 2014-09-12 | 富士フイルム株式会社 | 脈波伝播速度の測定方法及びシステム並びに撮像装置 |
WO2014155750A1 (ja) * | 2013-03-29 | 2014-10-02 | 富士通株式会社 | 血流指標算出方法、血流指標算出プログラム及び血流指標算出装置 |
EP3232908B1 (de) * | 2014-12-16 | 2022-09-21 | Oxford University Innovation Limited | Verfahren und vorrichtung zur messung und anzeige eines hämodynamischen parameters |
WO2016154256A1 (en) * | 2015-03-25 | 2016-09-29 | Quanttus, Inc. | Contact-less blood pressure measurement |
CA2952485A1 (en) | 2015-12-21 | 2017-06-21 | Robert Andre Amelard | System and method for spatial cardiovascular monitoring |
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2019
- 2019-03-20 EP EP19713735.9A patent/EP3768157A1/de not_active Withdrawn
- 2019-03-20 WO PCT/EP2019/056928 patent/WO2019180065A1/de unknown
- 2019-03-20 CN CN201980034203.3A patent/CN112218576A/zh active Pending
- 2019-03-20 US US16/982,207 patent/US12011250B2/en active Active
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US20210068670A1 (en) | 2021-03-11 |
WO2019180065A1 (de) | 2019-09-26 |
CN112218576A (zh) | 2021-01-12 |
US12011250B2 (en) | 2024-06-18 |
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