EP3768157A1

EP3768157A1 - Device and method for recording and analysing images of the skin

Info

Publication number: EP3768157A1
Application number: EP19713735.9A
Authority: EP
Inventors: Heiko Redtel
Original assignee: Individual
Current assignee: Individual
Priority date: 2018-03-20
Filing date: 2019-03-20
Publication date: 2021-01-27
Also published as: US20210068670A1; CN112218576A; WO2019180065A1

Abstract

The invention relates to a device and a method for the contact-free analysis of changes to skin colour in living organisms, in particular in humans. Images of a skin region to be examined are recorded by means of one or more cameras and are then analysed, in digital form, by a computer unit. In particular, one or more colours or one or more spectral ranges can be identified in a temporal sequence of occurring intensity changes, and on this basis inferences can be made regarding vital functions, in particular heart rate, pulse wave and the temporal and spatial profile thereof. Data can be derived on this basis which can be used to determine the state of health of the examined individual.

Description

Apparatus and method for taking and analyzing images of the skin

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. By means of stationary or mobile remote measurement, measurement using a camera or an analysis of stationary images obtained elsewhere or moving images of a living organism, such as, for example, a human, changes in the skin color can be detected. In turn, conclusions can be drawn from these changes, e.g. on the physical achievements of the organism. In particular, 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.

Today's camera technology is so advanced that it is far superior to the human ability in terms of spatial, color and temporal resolution, as well as in the color field. When these advanced properties are targeted and used in combination with modern analysis methods, the world can be recognized and presented in a way that has never before been possible. Especially in the medical environment, a comprehensive analysis of still images, but especially of moving images can be helpful and at the same time gentle for the patient.

The advantage of non-contact image acquisition and its evaluation, as well as a basis for later to be performed diagnostic of He diseases consists in the simplicity and at the same time a possible mobility ei ner corresponding device.

1 . Theoretical backgrounds

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.

Among other things, diseases alter the skin color, as well as the time-constant circulation of blood vessels and tissues of a living organism.

In time with a heartbeat, e.g. in humans supplied by the Pulsdruckwel len vessels, tissues and organs. The pulsating circulation of vessels and tissue also produces a temporal color change in the skin color in time with the respective pulse.

In a living organism, as in humans, the supply by the pulse pressure wave is based on a principle of physical necessity and the respective structure. Starting from the heart, 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.

2. State of the art

2. 7 State of Motion Picture Analysis Techniques

Existing software solutions for the device and method for image analysis of skin photographs are based on the analysis of color changes by means of spectral analysis or use the concept of so-called video magnification, where smallest movements are displayed enlarged. An example of such an implementation is the software Vital sign camera from Philips.

All previous systems only determine the pulse rate as an average over the total area of the skin. The determination of the frequency of the respiration is also carried out, however independent of the pulse by the movement of the breast with the respiration.

2.2 State of the Camera Techniques

Today's cameras record moving pictures. In this case, 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.

In today's cameras intended for the consumer, 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.

However, there are not only cameras for the visible to the human Be rich. Technically, a significantly larger area of the electromagnetic spectrum can be imaged. This range extends from terahertz radiation to X-rays.

2.3 State of the analysis techniques of vascular diseases

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.

2.4 State of the analysis techniques of skin lesions

Today's applications of Klara (formerly Goderma) allow the analysis of skin lesions. These systems can only detect the size of individual nevi or other skin lesions and compare them to later images.

In 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.

2.5 Extension of described procedures

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. As the blood cells move with the heart pulse, they are sometimes faster and sometimes slower. 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. By analyzing the reflected sound frequency, the speed of the blood cells can be determined and then graphically displayed. The 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. Here, 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.

3rd invention

The invention aims to provide an improved compared to known systems methodology and an improved device to improve the data in a berührungslo 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.

In particular, it is an object of this invention to provide an apparatus and method that can obtain basic data on the cardiovascular system from still images or, preferably, from moving images.

This object is achieved by a device having the features of claim 1. An. Advantageous developments are given in claims 2 to 12. A task solving method is designated in claim 13. Before some refinements of this method are shown in the claims 14 to 41.

With 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. Thus, 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. On the other hand taken into account 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. On the other hand, 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.

These extended possibilities of measuring a living organism, in particular a human being, make it possible on the basis of the measured values to carry out extensive medically relevant analyzes, which are listed in Chapter 4 and whose implementation is presented in Chapter 6.

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.

In particular, these enhancements across existing technologies allow for a deeper assessment of a human's cardiovascular system based on the data collected. For example, 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 lengeschwindigkeit between arms and legs can point to already beginning closures, so that timely countermeasures can be taken. In addition to these data, 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).

If one uses the pulse measurement at different body parts and Extremi activities simultaneously, pulse wave velocities are measurable. The so-measured pulse wave velocities are by comparison another diagnostic means.

From the pulse pressure curve, or the pulse wave analysis, and from the pulse wave variability diseases and stress states can be determined.

For the method according to the invention, the use of a camera which picks up in the visible light or in the near infrared range is advantageous.

In addition to the color recording capabilities of a camera, today's cameras, which are intended for the consumer, partially feature internal color enhancement algorithms. Although these produce a picture that is more beautiful for the observer, however, these color improvements are detrimental to the inventive method. Therefore, so-called. Industrial cameras or cameras for professional video recording for use in the inventive method are advantageous.

In addition to the color resolution or exact color reproduction, 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.

For detection of the cardiac pulse over the expected maximum range, ie in particular of 25-300 beats per minute and at a required resolution of 5 in the range around 300 beats per minute, 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.

If 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.

For surveillance tasks, eg in public places, a combination of two cameras or a camera with different zoom settings must be used. 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. Here, too, only 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. In addition, the use of moving images can make further skin changes visible. Thus, e.g. so-called Feuermale by an altered circulation. With the invention, the true size sol cher Feuermale due to the differences in the blood flow can be identified ge.

In particular, 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. In this case, 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.

Since the invention presented here operates over a large area, brightness fluctuations can be detected so that they do not lead to incorrect measurements.

4. Applications

The advantage of the non-contact measurement according to the invention for the diagnosis of diseases lies in their simplicity and the possible mobility. By 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. Ί Analysis of the human cardiovascular system

Due to a change in skin color, the invention recognizes diseases such as peripheral arterial occlusive diseases (PAOD). Examples of PAOD include diabetic foot syndrome (DFS), smoking legs, varicose veins, atherosclerosis, macroangiopathies or microangiopathies.

These diseases are manifested by the absence or reduction of the arterial pulse in a tissue region. This can lead to the death of the web and should therefore be recognized in good time so that effective countermeasures can be taken.

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.

Since the described invention can also perform a spatially resolved measurement, 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.

If the frequency of the heart pulse is determined for each heartbeat, 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.

From the comparison of at least two waves at different locations, 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.

In the picture, 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. Since the size of larger arteries becomes visible in the image, 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.

Furthermore, in particular the measurement of no arterial pulse pressure contours or pulse waves is a feature of existing diseases on corresponding body or skin areas.

Peripheral arterial disease (PAD) is a macroangiopathy resulting from progressive atherosclerosis of the leg and foot vessels. Dia betetic foot syndrome (DFS), on the other hand, is a microangiopathy that leads to typical changes in foot stasis, tissue perfusion, and protective functions of the foot.

The macroangiopathy underlying PAOD can be treated by means of revascularization measures. For macroangiopathy of DFS, there is no causal therapy option. In Germany, approx.

80,000 amputations carried out annually, attributable to these diseases. By increasing diabetic diseases, the numbers of amputations increase annually.

The procedures and analyzes presented so far can be carried out with conventional cameras using natural light. By using light colors that are not visible to the human eye, and using appropriate cameras, other medically interesting applications can be made possible.

Interesting is the use of light in two different spectral regions, which are also used in pulse oximetry. The typical wavelengths used are 760nm and 950nm. At these wavelengths, the light absorption behavior of hemoglobin is dependent on the Oxygen saturation. If a picture is taken in which a color channel exists for both colors, the arteries and the veins are visible in both, and the subtraction of one color channel from the other produces an image of the arteries or veins. The following measured values can be determined:

• Local distribution of oxygen saturation in the blood

• Pulse in the arteries

• Pulse in the veins

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. As a result, the veins are stretched. A first and well-known sign of this is varicose veins. In addition, 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

4.2 Analysis of human skin and tissue

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. For example, 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 Temperaturände 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.

4.3 Further applications of naturopathic practice

In the natural healing practice many diagnostic methods are used, which are based on the analysis of color changes or their effect can be assessed by the recognition of color changes in their effect. These are, for example:

• Eye diagnostics

• Effect of Kneipp applications

• Examination of the head zones

In 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.

By the invention, a color intensity change of the iris can be made locally resolved. The temporally resolved intensity changes tion, however, 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. In the context of this invention, 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.

In the case of organ disease, alternative medical methods try to irritate the head's cells in order to improve the internal organs. By analyzing the effects of these treatments, the success of these treatments can be determined.

4.4 Other applications

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.

In addition to a occlusive disease sports also leads to a change in the blood circulation. Moderate exercise increases blood circulation, and in case of excessive and thus damaging sport, protective mechanisms of the body reduce blood flow in the outer extremities, resulting in the formation of cold sweat. Both reactions can be recognized. The increase in blood flow at the beginning of a sporting activity and its decrease in a break are an indicator of the regenerative ability of an athlete. Thus, the ability to regenerate is measurable and trai nable for the athlete.

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.

If a person is under stress, the heart rate is increased and the breathing is flat. With pleasure the pulse is increased and the breathing is strong. The sensation state can be useful in a variety of applications:

• video games

• monitoring, e.g. at the passenger control at the airport

• Telemedicine

• TV shows, e.g. Talk Shows

• attention monitoring, e.g. in the load and passenger traffic

Quality feedback of a service, such as Recognition of the condition before and after a visit to a recreational facility

• Detecting the impact of an advertising message

Of course, all applications are not only applicable to humans, but in principle also in all vertebrates with blood circulation. Example of this is e.g. the medical monitoring of expensive racehorses or the detection of a stress-free slaughter of fattening animals.

5. Technical realization

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. The term color is to be understood in particular as being common in the following. In addition to the colors perceptible by the human eye, there are other light colors which are physically described by a wavelength. 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).

For detecting the pulsating changes in the skin surface, light wavelengths in the visible range and in the infrared range are suitable. In the visible range, these are wavelengths of the green and blue-violet light of 380-570 nm. In this area, the pulsating change in the skin surface can be recognized by the brightness change caused by filling the arteries with blood. In 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. In particular, 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.

Advantageously, 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.

5. 1 Analysis of moving images

The invention uses a special device and a method to detect the durchlau fende pulse wave. For this are moving pictures of the Surface of the skin of a living organism, such as a human ge uses.

Starting from the heart, 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. 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. With a camera in special resolution and with a special frame or frame rate per second, this change can be measured. The measurement of Herzpul ses as a frequency, is possible at any suitable body site. The more powerful the camera, 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 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).

For this purpose, 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.

Depending on the equipment and performance of the camera, the total surface or parts of the skin surface can be measured. In this case, 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 methods presented here are already known in principle, but in their composition and in their optimization to the detection of the pulse wave novel.

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.

First, in this section, the high-temporal detection of the pulse wave is explained in one place.

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:

• Detection of the body or body parts in the picture

• Limitation of the image to be examined

• Tracking of the image section during movement

• Adjusting the image section in size and shape when rotating or changing the position of the body with respect to the recording unit

• Quantification of the color in the image section

• Analysis of the most suitable color in the image section

• Analysis of the temporal change of the color to generate the pulse wave

• Pulse wave analysis for intensity, RR interval, respiratory rate and application specific features Detection of the body or body parts in the image:

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.

Limitation of the image to be examined:

If, for example, a measurement of the pulse is performed on the forehead, 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.

If a high resolution is required, 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.

Tracking the image when moving:

For accurate detection, the exact area on the skin surface in each frame of the moving image must be examined. As the organism to be examined moves, the detail in the image also moves, causing it not only to change its position, but also its shape and size in the image. These changes, even the smallest changes, which are present even with kon centered resting a person and not suppressible, must be recognized to allow for appropriate adjustments. This can be done by repeating the previous steps for each image. However, this is not very accurate because the recognition position and size of the recognition algorithms are not always accurate, making the tracking inaccurate. In addition, these algorithms require a lot of computation time. A strategy adapted to this task is to recognize individual points in the first image that are traceable. These points must have points on the skin surface near or in the frame. Well-known algorithms can be used for finding suitable points and tracking them.

Adaptation of the image section in size and shape during rotation or Variegated tion of the position of the body with respect to the receiving unit:

By tracking points on the skin in the image, 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.

Quantification of the color in the image section:

The previous point described how to trace a section of skin from image to image. 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:

Here is | A | the area of the skin portion A, c (p) the color of the pixel p and □ (p, A) a function that outputs a value between 0 and 1, depending on whether the pixel is completely (D (p, A) = 1) or not (D (p, A) = 0) in A, intermediate values reflect the area fraction of the pixel in A.

Analysis of the most suitable color in the image section:

The data important for the analysis are obtained directly from the color information. In the simplest case, 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.

This can be done in two different ways. On the one hand, today's common camera models produce a color image by taking the image three times using internal color filters. On the other hand, a color filter specialized for the task can be used to better determine medically meaningful quantities. When using a commercially available Farbka mera the light is filtered, typically using color filters for the green, the blue and the red color component. The sensitive area of a pixel is subdivided into four sensitive areas or subpixels. One area each is covered by one of the three color filters. The fourth area is either not sensitive or covered with a green color filter. The use of two areas with a green color filter makes sense, since the human eye is optimized for the color green.

These three color filters let only the red, the green or the blue light through. These colors are sufficient to represent a colorful image for humans. For the detection of medically relevant sizes, the se colors are partially usable. However, the internal color filters are not exactly the same for each camera model, therefore, the color component must be selected, which has the most conspicuous brightness fluctuation, which is used to determine the pulse ver used. Therefore, the following analyzes are carried out for all color components, resulting in a timely progression of the brightness fluctuation from the colors accessible from the camera. This one will, like how Filtered below, so that only the time course of Hellig keitsschwankung due to the heart pulse can be seen. From these courses, a measure of the fluctuation, this can be, for example, the standard deviation to the mean, determined. The curve with the highest level of fluctuation is used for the analysis of vital signs.

If the exposure remains similar and the camera used is the same, the color content once found in a human being can usually be used by other people as well.

Sony cameras (Handycam hdr-sr1, Red Dragon, industrial camera based on an IMX290 sensor) showed a clear variation in the green color component and less in the blue color component, whereas in the red component there was no fluctuation with the heart pulse. Other camera models (as used in the Huawei Mate 8 or 9) showed slight fluctuations only in the blue part of the color. However, in a variety of cameras, especially from the consumer sector, no fluctuation can be detected. This circumstance is on internal filters for alleged better representation zurückge leads.

Analysis of the temporal change of color to generate the pulse wave:

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.

The effects of movement are suppressed by the already described tracking of the skin section. Examples of the effects of "bad" light are as follows: Flickering of lamps for illumination, many lamps flicker depending on power network and design, with the usual power supply in Germany this means flicker at 50 or 100 Hz. Sudden changes in brightness when daylight is used, the movement of clouds can suddenly change the brightness; indoors, the movement of persons for shadows. Gradual change in light intensity; when using daylight there is a change in light intensity due to the passage of the sun; indoors, the use of lamps that need to heat up first to reach their full intensity can cause a change in light intensity. Both forms of change are normally, with the exception of the evening and morning hours or directly after switching on lamps, imperceptible to the human eye, but such a change is already sufficient to cause measurable changes.

These effects are counteracted as follows:

First, 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 change in brightness is not yet optimally usable for further analysis, due to the gradual changes in intensity and the one-time sudden changes. Therefore, the signal must be reduced by its intensity offset. For this purpose, 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. In particular, a weakening of the frequencies greater than 0.5 Hz before geous. The result is the signal background.

The signal adjusted for interference with high frequencies and the Signalun tergrund, resulting from the noise-free signal from the signal background is pulled off. An exemplary dataset is shown in Figure 1, reference numeral 1-1.

If a professional camera is used, in particular one with a frame rate of 300 fps and a color dynamic of 24 bit or more, with a flicker-free illumination, the adjusted signal can be examined for local minima and maxima. Here, the data at the time and the data on the intensity of the minima, or maxima. The person skilled in suitable procedures for the determination of local minima and maxima are known from such a signal.

Analysis of the pulse wave with regard to intensity, RR interval, respiratory rate and to application-specific characteristics:

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. When inhaling, 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.

5.2 Analysis of a single image

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. Everyone 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. In this algorithm, a point on the skin surface is tracked from image to image. Corresponding pixels are used at a point on the skin. Instead of a fixed point on the skin, when analyzing a frame, 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. In this case, the areal and positional data are determined in units of pixels or pixels $ ^{^} 2 $ and can be converted to SI units via a scale. For this purpose, either 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.

In addition to the data of the individual skin changes, it is also possible to determine the data relating to the relationship between skin changes and skin abnormalities which are used for the following description. 5.3 Analysis of temporally successive individual images or of time-lapse images

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. For this purpose, 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. Under ideal conditions of exposure and orientation of the skin surface to the camera, 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.

Under realistic conditions, it is not possible to create the same exposure and the same orientation of the body to the camera from one image to a later, later image. However, nearly identical states can be created. The problem of exposure, as long as the exposure is sufficient, plays a minor role in the process and is essentially solved by the methods in the previous sections. The problem of a different area between two images is solved by calculating the change between the two images and, accordingly, deforming and rotating an image so that the distorted and rotated (medically unchanged) liver spots on the other image are de nen fit. The problem of adapting a first image to a later captured second image therefore consists of five points:

• 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 adaptation of two images to each other is achieved by known algorithms of image correlation. These algorithms recognize and track points or dot patterns in consecutive images and can thus solve the problems already.

After two temporally consecutive images have been aligned, 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.

6. Logics

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.

With the invention it is possible to create a 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.

In the previous chapter (Chapter 5) it was shown how an area of the skin can be analyzed with regard to vital data. By analyzing several areas of the skin at the same time, further measurable parameters of the condition of the circulation of the tissue under the skin result.

The areas that are tracked and used for analysis are also called chalices. Advantageously, 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 following parameters can be determined by the simultaneous analysis of several areas:

• Find micro and macroangiopathies

• Pulse wave velocity

• Detection of atherosclerosis

• imaging the course of arteries of veins

Furthermore, 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.

• Identification of "suspicious" sites where tissue below the site may be suffering from micro or macroangiopathy or atherosclerosis.

• Spread of the pulse to the surface of the skin, representing the pulse wave velocity

• Use of the propagation of the pulse to show the course of arteries and veins.

• 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.

6. 1 Possible sequence of a measurement

Depending on the application, either a part or parts of the 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.

If a large area of the skin or the entire skin surface is to be examined, a distinction can be made between two classes of application. On the one hand, 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. On the other hand, 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.

In the section-wise examination, each section is advantageously recorded and then analyzed. The section examination can be performed in different complexity as follows. On the one hand, 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.

However, manual alignment of the camera is not beneficial because it takes a long time and is error prone. Automated alignment is advantageous. In principle, two methods are applicable. On the one hand, the camera can be moved mechanically and, on the other hand, a system of movable mirrors can be mounted in front of the camera, which can be aligned so that the different skin areas to be examined are mirrored into the camera. Another method is the movement of the person to be examined.

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. Here, 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.

Today's industrial cameras have very high spatial resolutions and a good temporal resolution. The temporal resolution of these cameras can be increased by limiting the area to be recorded, the restricted area is called AOI (Area Of Interest). Thus, these cameras provide a solution for recording large areas of the skin surface. The AOI is shifted in sections and then an appropriate recording is performed.

An important special case is the simultaneous admission of two skin areas simultaneously. Medically interesting is the comparison between the right and left half of the body or between a body part on the left and the corre sponding body part on the right side. Thus, for example, the pulse wave transit time between the right and left foot can be observed, wherein the time difference of the pulsating color changes due to the heart pulse is founded in that the heart is far away from the two feet due to the non-central position of the heart in the body , If the two halves of the Ge are examined, then a normal shifted time interval of the pulse waves on both sides may indicate a blockage in one of the two dermal arteries leading into the head.

6.2 Au ff by Micro and Makroangiopathien

An angiopathy is indicated by the absence of a pulse in a region of the tissue.

This is indicated by 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.

This is achieved as follows: 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.

Up to this point, only the heart pulse is shown locally resolved.

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.

6.3 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. Starting from larger arteries, 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.

To determine the pulse wave velocity, 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.

6.4 Detection of cardiac arrhythmia or arrhythmia

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.

6.5 Imaging of the distribution of arteries and veins

Arteries are visualized by analyzing the intensity fluctuations. Within an artery, the intensity fluctuations are constant in their maximum intensity, as long as the distance to the surface and the diameter of the arteries is constant. The normalized and scaled intensity waves of all tiles are now examined for maximum intensity. Now the tiles are colored on an overlay with the same color, which have the same or almost the same maximum intensity; it gives a picture of the arteries.

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.

6.6 Illustration of the pulsation of the arteries in relation to each other

After the tiles have been assigned to the individual arteries or 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.

6. 7 Common presentation of all determined data in a display

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:

• Display of the entire detected body area (2-1);

• Choice of body area selection (2-2);

• Pictorial display of the selected body area (2-3);

• Display of the time course of one-dimensional data (2-4);

• marker and symbol for selecting the position for the time course of one-dimensional data (2-5);

• displaying the one or more one-dimensional data at the currently displayed time (2-6);

• Selection tool and display of the time to be displayed (2-7);

• Setting the playback speed (2-8);

• At least one timeline, representing significant events over time (2-9);

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);

• Overlay of the selected body part with a semi-transparent one

Layer, which shows a representation of the measured data for each point or tile and chronologically with the change of the measured data in terms of their transparency and / or color representation at each point or tile depending on the time course of the measured data for the latter Point or this tile on the skin changed (2-1 1); • Selection of a specific examination method (2-12);

• displaying all and a selected amount of one-dimensional data at the current time as a pie chart (2-13);

• Selection setting for selecting a set of one-dimensional data (2-14);

• setting a cut through the data (2-15);

• Displaying the cut through the data as an overlay in the display of the selected body area (2-16);

• displaying one or more determined values for the two sides as an indicator on a scale; This scale can be variable colored or equipped with value markers. Furthermore, an optimal point or normal value or normal value range can be brought in by healthy users on the scale (2-17).

If a measurement is carried out, an initially unmanageable large amount of data is available. These data are initially of two-dimensional nature and above some high resolution. A display must first give an overview, this is shown in Figure 2, reference 2-1. It is the entire survey ne area shown schematically, here the entire body from the front. With an option tool (2-2), the area to be displayed in the display (2-3) can be selected. The location and size can be changed In addition, 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 Furthermore, 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. Advantageously, 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. Advantageously, 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. is 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. The use of the pie chart allows the display of different data to each other and also indicates whether the relation of the vital data with each other to a healthy state of the body corresponds to and at a glance. In order to make noticeable anomalies over time at a glance, a timeline (2-9) is available. It shows (2-7) marks (2-19) next to the current time position, which indicate irregularities. There are various types of markers on the timeline and in the other display elements ((2-3) and (2-4)) used to mark different types of abnormalities. In addition to the temporal marking of conspicuities, a marking within the pictorial display of the two-dimensional data (2-3) and the graphic data (2-4) is also possible.

Medically interesting is the evaluation of differences between the left and right half of the body or between two parts of the body. For this purpose, 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). In addition, 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. These Displacement symbolizes the typical differences of 3-8 ms of transit times. The indicator relatively indicates the determined transit time difference. In this case, 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.

Description of the pictures

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. In addition to the choice of data, 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). In addition to the actual display, 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)

Claims

claims

1 . Apparatus for measuring variable skin color data of a living the organism, in particular a human, in particular for medi cal diagnostic, for a therapeutic accompaniment and / or kosme tables purposes, with at least one digital image data providing Ka mera and a computer device for the evaluation of the of at least one digital image data provided by the camera, wherein the computer unit is set up and configured to analyze the digital image data spatially and temporally and temporally in relation to changes in the skin color that actually occur on the skin.

2. Device according to claim 1, characterized in that the computation

Nerein configured and adapted to analyze the intensity of a color component or a wavelength of light of an image in an image sequence.

3. Apparatus according to claim 2, characterized in that the computation

Nerein configured and configured to analyze the intensity of a color component or a wavelength of light of a plurality of images in a sequence of images and set in comparison.

4. Device according to one of the preceding claims, characterized in that the computer unit is set up and designed to divide an image in an image sequence in tiles and Sieren for each of the tiles to analyze.

5. Device according to one of the preceding claims, characterized in that the computer unit is set up and formed from the determined data of a temporal and / or spatial course of real occurring on the skin changes in the skin color the pulse, a pulse wave contour, a pulse transit time To determine a pulse wave velocity, a pulse wave variability and / or arrhythmias.

6. Device according to one of the preceding claims, characterized in that the computer unit is set up and configured to emerge from the determined data of a spatial course of real on the skin. Changes in skin color determine changes in a given skin area over time.

7. Device according to one of the preceding claims, characterized

records that it comprises a display and that the computer unit is set up and designed to graphically display determined data and analyzes performed on the display.

8. Device according to one of the preceding claims, characterized in that the at least one camera is a set for recording of Vi deosequenzen camera.

9. Device according to one of claims 1 to 7, characterized in that the at least one camera is a directed camera for taking single images.

10. Device according to one of the preceding claims, characterized in that it comprises two or more, on different target areas aligned cameras.

1 1. Device according to one of the preceding claims, characterized in that it is integrated in a mobile device, e.g. in a mobile, camera-equipped smart device, such as a smartphone, tablet PC or the like.

12. Device according to one of the preceding claims, characterized in that it is formed as a stationary unit.

13. A method for particularly mobile detection of data on living organism, preferably on a human, in particular for a use in medical diagnostics, for a therapeutic accompaniment and / or for cosmetic applications, characterized in that individual images and / or moving images be absorbed by a skin area to be examined and spatially resolved in at least one color and / or spectral range, preferably in at least two different colors and / or spectral ranges with respect to temporal and / or spatial intensity changes

14. The method according to claim 13, characterized in that the area to be examined is selected to be stationary on the skin surface and that this area is determined in a sequence of pictures within each picture.

15. Method according to claim 14, characterized in that two or more images recorded at different times are superimposed and rotated relative to one another such that the skin area to be examined overlaps congruently in both images with respect to size and orientation.

16. The method according to claim 15, characterized in that the mutually aligned at least two images are compared with respect to the skin area to be examined and analyzed with respect to a change of the skin in relation to particular size and color of skin structures.

17. The method according to any one of claims 13 to 1 6, characterized in that intensity changes of the at least one color and / or the at least one spectral range along a straight line in a single image are detected and evaluated.

18. The method according to claim 17, characterized in that intensity variations of the at least one color and / or the at least one spectral range along a multiplicity of mutually parallel straight lines are recorded and evaluated in a single image.

19. The method according to any one of claims 13 to 18, characterized in that the skin area to be examined in the at least one image in Ka smile whose area is compared with the surface of the skin to be examined at least smaller extent that a plurality of such tiles , in particular at least 20 such tiles results, is divided.

20. The method according to claim 19, characterized in that a division into tiles with a diameter and / or with edge lengths of less than 1 mm.

21. Method according to one of claims 19 or 20, characterized in that the location and area of one, several or all tiles on the skin surface are determined.

22. The method according to any one of claims 1 9 to 21, characterized in that the temporal change of the intensity of the at least one color and / or the at least one spectral range is determined for each tile and is displayed in a resulting wave-shaped course.

23. The method according to claim 22, characterized in that the waves of the wave-shaped course normalized and scaled on the basis of the totality of the waves.

24. The method according to any one of claims 22 or 23, characterized in that the waves are examined in the waveform in terms of local minima and maxima.

25. The method according to claim 24, characterized in that the temporal identity of minima and maxima of the different Wel len are evaluated with regard to the heart pulse.

26. The method according to claim 25, characterized in that the evaluation takes place with respect to the heart pulse for each heartbeat.

27. The method according to any one of claims 25 or 26, characterized in that from the evaluation of the heart pulse for each heartbeat Pulse riabilität is determined.

28. The method according to any one of claims 25 to 27, characterized in that the temporal difference associated minima or maxima for each tile in relation to the minima or maxima of a selected th tile determined and from a pulse travel time is determined.

29. The method of claim 28, when dependent on claim 22, characterized in that from the location and the pulse wave transit time of each tile, the pulse wave velocity is determined for this tile.

30. The method according to any one of claims 25 to 29, characterized in that all waves are normalized together, in particular to a value between 0% and 100%, and that this standard is interpreted as a degree of Durchblu tion of the tissue area under the associated tile ,

31. Method according to one of claims 22 to 30, characterized in that the amplitude between a local minimum and a temporally successive maximum of the wave of each tile for all minima or maxima is determined.

32. The method according to claim 31, wherein at a marking of the tiles in a graphic representation of the tiles over an image of the examined skin surface on the basis of a restricted area for the value of the amplitude between the minima and the following maximum of the wave of the tiles Arteries characterized by similar diameters and depth under the skin are displayed in a graphical representation.

33. The method according to any one of claims 19 to 32, characterized in that for each of the tile determined data will be interpreted as two-dimensional data.

34. Method according to claim 33, characterized in that a depiction of the two-dimensional data as a color or partially transparent marking of a surface of the respective tile takes place on an overlay over an image of the examined skin area as a function of the value of a date assigned to the respective tile.

35. The method according to claim 34, characterized in that a type of the displayed data can be set on an overlay.

36. The method according to any one of claims 34 or 35, characterized in that an overlay can be generated at any arbitrary measurement time even after a measurement based on stored data.

37. The method according to any one of claims 34 to 36, characterized in that markings are introduced in an overlay, which indicate fixed anomalies, in particular to possible diseases.

38. The method according to any one of claims 19 to 37, characterized in that in a display determined data by the use of a Kreisdi agramms are related to each other, wherein on the one rule between tween groups of tiles and / or between skin areas a separate te display is present and on the other hand, an indication of individual data in relation to each other is made possible.

39. Method according to claim 19, characterized in that a scale with indicator illustrates a relation of values of two groups of tiles to one another, this scale comprising markings which characterize a medically healthy state and comprises an indicator which indicates the determined state.

40. The method according to any one of claims 13 to 39, characterized in that at the same time images of different skin surface sections to be manufactured and analyzed comparatively.

41. Method according to one of Claims 13 to 40, characterized in that the images are recorded in the region of the infrared spectrum and / or analyzed for at least one color and / or at least one spectral region of the infrared spectrum.