JP3854888B2 - Atherosclerosis detection system - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to an arteriosclerosis detection system.
[0002]
[Prior art]
The present inventor believes that in order for the elderly to become independent, a preventive medical approach that prevents the onset of various diseases as well as the mental awareness of the individual is essential. And a means for simply and accurately detecting arteriosclerosis, which is a causative factor in many cases of cardiovascular disease.
[0003]
That is, the inventor of the present invention provides an electrocardiogram signal detection means capable of detecting an electrocardiogram signal, an electrocardiogram signal detection means for sensing a specific pattern of the electrocardiogram signal, and a specific electrocardiogram signal sensed thereby. An arteriosclerosis detection device provided with a fundus image detection means capable of detecting a fundus image in synchronization with a pattern has been provided (WO01 / 30235A1). This detection device makes it possible to accurately measure the diameter of the fundus artery and fundus vein using a fundus photograph, regardless of the time difference between the diastolic and systolic phases of the heart due to the wind kessel phenomenon. It was also possible to grasp the degree of progression of arteriosclerosis using as an index.
[0004]
[Problems to be solved by the invention]
The inventor is convinced that the detection of arteriosclerosis by this arteriosclerosis detection device is very significant in preventive medicine, and it is necessary to take measures to further generalize this device. I thought it was.
[0005]
[Means for Solving the Problems]
As a result, the present inventor overcomes the above problem by performing synchronization of the electrocardiogram signal and the fundus image on the computer screen, which is one of the most important and difficult processes in the above detection device. The present invention has been completed.
[0006]
  That is, the present invention relates to an arteriosclerosis detection system comprising an electrocardiogram signal detection means and a fundus image detection means capable of detecting a fundus image synchronized with the electrocardiogram signal detected thereby. Artery performed by software capable of providing a fundus image synchronized with an electrocardiogram signal by extracting a still image of the fundus synchronized with an arbitrary electrocardiogram signal from a moving image of the fundus image on a computer display screen. A curing detection system,The software calculates the degree of stenosis of the fundus vein near the intersection of the fundus artery and fundus vein for different ECG signals, and associates the integrated value of these calculations with the degree of arteriosclerosis. , Software with a means to detect arteriosclerosisThe present invention provides an arteriosclerosis detection system (hereinafter also referred to as this detection system).
[0007]
The present invention is also an invention that provides software (hereinafter also referred to as this software) that can provide a fundus image synchronized with the above-described electrocardiogram signal.
The software is preferably software that can extract a fundus image synchronized with a specific pattern of an electrocardiogram signal while simultaneously displaying a fundus image and an electrocardiogram video on a display means in a computer terminal. .
[0008]
The “electrocardiogram signal detection means” in the present detection system is not particularly limited as long as it can accurately detect the electrocardiogram signal. For example, an electrode sensor composed of a piezoelectric element is connected to the chest of the subject or other living body part. And a means capable of detecting the derived electrocardiogram signal. Typically, a mechanism provided in an existing electrocardiograph can be used as a means for detecting an electrocardiogram signal.
[0009]
The electrocardiogram signal to be detected is not particularly limited as long as it is a signal that can be grasped as an established pattern on the electrocardiogram, and any pattern of P wave, Q wave, R wave, S wave, or T wave can be selected. However, it is preferable and realistic to select the R wave, which is a pattern signal at the stage of discharging blood from the heart toward the body, or the T wave indicating the recovery process of ventricular excitation. . In this detection system, this software extracts a still image of the fundus synchronized with an arbitrary electrocardiogram signal from a moving image of the fundus image on the display screen of the computer, and the fundus image synchronized with the electrocardiogram signal is obtained. It is possible to extract a fundus image that is provided and synchronized at an arbitrary timing, but the pulse wave pulsation timing of the heart corresponding to the R wave and the T wave is the most prominent timing in the pulse wave pulsation cycle of the heart. It is. Therefore, it is one of preferred embodiments that an arbitrary ECG signal extracted in this detection system includes a signal indicating the R wave and / or T wave of the ECG signal (this will be further described later). To do).
[0010]
In addition, the guidance method for obtaining an electrocardiogram signal from the subject is not particularly limited, and can be selected from so-called “standard 12 leads” or the like. It is preferable that the reference for selecting the guidance method is the type of the specific electrocardiogram signal to be selected. That is, it is preferable to select a guidance method that is as easy as possible to detect a specific electrocardiogram signal. When an R wave is selected as a specific electrocardiogram signal, a potential difference between the left hand and the right hand of the subject is detected, leads II, I,_aV_LInduction, V₁It is preferable to select induction or the like.
[0011]
The “fundus image detection means” is a means capable of detecting a fundus image in synchronization with an electrocardiogram signal detected by an electrocardiogram detection means.
In the present invention, “synchronize” means that the fundus image detection means is made to respond at a certain timing to a specific pattern of the electrocardiogram signal. For example, when an R wave is selected as a specific pattern of an electrocardiogram signal, this means that the fundus image detection means is operated at a certain timing from any time point in the R wave, for example, the rising time point. This timing is kept constant, and if the timing is shorter than the timing at which the same pattern of the electrocardiogram signal is generated again (for example, if the R wave is the next R wave is generated) There is no particular limitation. In this way, by detecting the fundus image in synchronization with the electrocardiogram signal, information on the fundus blood vessel, specifically, information on the blood vessel diameter indispensable for obtaining an index of arteriosclerosis in the present invention can be accurately obtained. Can get to. That is, as described above, in the fundus photograph taken arbitrarily at any time, it was difficult to accurately evaluate the fundus blood vessel diameter that changes in accordance with the expansion and contraction of the heart due to the wind kessel phenomenon. If the fundus image is detected in synchronization with the electrocardiogram signal, it is possible to obtain a fundus blood vessel image at a constant pulse wave pulsation timing, and it is possible to accurately evaluate the fundus blood vessel diameter.
[0012]
As a fundus image detection means, a camera having a mechanism capable of photographing the fundus (specifically, a so-called fundus camera: an analog camera or a digital camera) may be mentioned. In the system, detection of a fundus image with a digital video camera that can be obtained continuously as digital image information is suitable for synchronization with an electrocardiogram signal of the fundus image in a computer.
[0013]
For example, a DV capture card such as a DV terminal (media converter is also possible), IEEE1394 card, EZDV (Canopus), DVRapter (Canopus), DVRex (Canopus), etc. The electrocardiogram signal converted into a digital signal by an A / D converter or the like is taken into the computer while taking it into the computer as digital information through the above. Next, the fundus image moving image data and the electrocardiogram signal are synchronized in the same frame by performing parallel compounding of the captured fundus image moving image data and the electrocardiogram signal data, so that the fundus image moving image data and the electrocardiogram are synchronized. Digitally synchronized data of the signal can be obtained. This digital synchronization data can be compressed as long as the elements necessary for carrying out the present detection system are not impaired. Encoding including such compression can be performed by following an encoding method such as MPEG.
[0014]
The digital synchronization data obtained in this way can be stored, for example, on a magnetic tape, magnetic disk, CD-ROM, MO, DVD-R, or the like. Note that these storage media are merely examples, and it is possible to use data storage media according to changes and improvements in data storage technology.
[0015]
In the digital synchronization data obtained in this way, calculation values (such as a V ratio described later) regarding the fundus image are calculated by extracting still data, that is, digital data in units of one frame.
[0016]
Also when calculating the amount of change per unit time of a calculated value such as a V ratio, which will be described later, image data of the fundus image at an arbitrary electrocardiogram signal (time t) is extracted from the moving image data, and an appropriate time is determined. The image data of the fundus image at the time of placement (t + Δt) can be extracted from the moving image data and calculated based on the still image data of both (as will be described later, t in this case is also synchronized with the moving image of the fundus image) It is preferable to select depending on the electrocardiogram signal.
[0017]
Extraction of still image data from digitally synchronized data of fundus image moving image data and electrocardiogram signal data is performed while simultaneously displaying the fundus image and the electrocardiogram moving image on a display means such as a computer display in a computer terminal. Thus, it is possible and preferable to visualize the extraction work. Therefore, it is preferable that the present software is equipped with the visualization means on the display means of the computer terminal as an algorithm.
[0018]
This software can be created by constructing a desired algorithm in a general computer program language.
As a computer program language, for example, low-level languages such as machine language and assembler language; Fortran, ALGOL, COBOL, C, BASIC, PL / I, Pascal, LISP, Prolog, APL, Ada, Smalltalk, C ++, Java (registered trademark) ) Or the like; a fourth generation language, an end user language, or the like can be selected and used. A special problem language can also be used as necessary.
[0019]
The electronic medium that can store the software is not particularly limited, and for example, a magnetic tape, a magnetic disk, a CD-ROM, an MO, a DVD-R, or the like can be used. The present invention also provides an electronic medium in which the software is stored (these storage media are merely examples, and data storage media can be used in accordance with changes and improvements in data storage technology). .
[0020]
As described above, the present detection system can obtain a fundus blood vessel image at a constant pulse wave pulsation timing. The arteriosclerosis of the subject can be detected by associating the information obtained from the fundus blood vessel image with the progress of the arteriosclerosis of the subject by the algorithm in this software. “Detection of arteriosclerosis” in the present invention refers to the degree of organic change in the blood vessel morphology of the subject's artery and the degree of extension or functional change, in other words, the flexibility of the artery (elasticity). This means detection of the degree. In other words, when this detection system shows the progression of arteriosclerosis, in addition to the organic changes in the subject's arteries, the elasticity decreases and the degree of extension becomes low, and the flexibility of the arteries. Is being lost. In such a case, for example, it means that the risk of ischemic disease is high.
[0021]
The manner of the above association is not particularly limited, but the information about the fundus blood vessel diameter detects the degree of organic changes in the blood vessels of the subject's arteries and the degree of flexibility using the algorithm of this software. Above, it is particularly useful information. Specifically, information about these fundus blood vessel diameters is obtained in this software using the conventional criteria for arteriosclerosis, for example, “the conditions of the 1969 Ministry of Education, Hypertension Research Group”, “K-W classification”. ”,“ Seheie classification ”, and the like, the degree of organic changes in the arterial blood vessels of the subject and the degree of flexibility can be detected.
[0022]
The present inventor has determined that the fundus artery and the fundus vein (in the present invention, “fundus artery” means “retinal artery” in medical terms, and “retinal vein” means “retinal vein” in medical terms). It has been found that the degree of stenosis of the fundus vein in the vicinity of the intersection (which shall mean) can be a very useful indicator that can be correlated with the progression of arteriosclerosis. The present detection system capable of obtaining a fundus blood vessel image at a constant pulse wave pulsation timing is very useful for obtaining this index.
[0023]
The degree of stenosis of the fundus vein can also be detected by directly observing the fundus image obtained by this detection system visually. Further, the fundus image detection means described above can be provided with a fundus vein stenosis detection means capable of detecting the fundus vein stenosis, and this process can be automated. As a means for detecting stenosis of the fundus vein, for example, the software detects, for example, an algorithm for detecting the intersection of the fundus vein and the fundus artery and / or the degree of stenosis of the fundus vein near the intersection. Mounting an algorithm or the like for doing so. By processing the above-described fundus image data with such software, it is possible to detect a desired stenosis of the fundus vein simply and reliably.
[0024]
Here, the index of stenosis of the fundus vein that is useful in detecting arteriosclerosis found by the present inventor will be described.
It is known that these fundus blood vessels share the adventitia at the intersection of the fundus artery and the fundus vein. When arteriosclerosis is observed at such a crossing portion, the inside of the fundus artery is hardened, and includes “tension force” (“slip stress”) due to hardening of the intima of the artery. In other words, the fundus vein causes stenosis in the vicinity of the intersection. As the stenosis due to the pulling force is more remarkable, it indicates that the arteriosclerosis has progressed in the vicinity of the intersection.
[0025]
The inventor found that the ratio of the outer diameter of the original fundus vein to the outer diameter of the fundus vein in the vicinity of the intersection of the fundus artery and the fundus vein (hereinafter also referred to as V ratio) is the intersection of the fundus vein showing arteriosclerosis. It was found to be extremely useful as an index of stenosis in the vicinity of the head.
[0026]
Specifically, the V ratio is calculated as follows.
FIG. 1 is a schematic diagram of the fundus artery and the fundus vein, in which the fundus vein is constricted, and the fundus vein 20 crosses the lower side of the fundus artery 10, and the fundus artery 10 is located near the crossover 30. The intima is cured (not shown), and a stenosis in the vicinity of the intersection 30 of the fundus vein 20 is recognized due to the pulling force due to the curing.
[0027]
  Assuming that the outer diameter of the fundus artery 10 is ΦA, a site separated by about 3 × ΦA from the crossover portion 30 to the distal side of the fundus vein 20 is confirmed, and the outer diameter of the fundus vein 20 at that position is pulled at the crossover portion 30. Considering this as the outer diameter of the fundus vein when no stenosis is observed, this is taken as V2 and the right side of the fundus artery 10 of the intersection 30 (for example, a distance of about 1/10 × ΦA from the intersection 30) Of the fundus vein 20Outer diameterIs V1.
[0028]
The ratio of V1 and V2 in this case (usually V1 / V2) is calculated as the V ratio. The smaller the V ratio (V1 / V2), the more the hardening of the fundus artery 10 in the vicinity of the intersection 30 is shown, indicating that the risk of arteriosclerosis is high.
[0029]
FIG. 2 is a schematic diagram showing a case where the hardening of the intima of the fundus artery 11 spreads in a direction slightly shifted from the crossing portion 31 (hardening portions: 111 and 112). As a result of the pulling force acting alternately in the vicinity of the crossing portion 31, it is shown that the fundus vein 21 is displaced in the vicinity of the crossing portion 31.
[0030]
In such a case, it is necessary to slightly correct the V ratio (V1 / V2) described above. Specifically, a vector line (211) connecting the centers of the left and right outer diameters of the fundus vein 21 across the fundus artery 11 at the intersection 31 is 0.5 to 1. When the deviation is 0 times, a correction value obtained by subtracting 0.1 from the above-described V ratio value is set as a V ratio to be used for detection of arteriosclerosis. Further, when the deviation of the outer diameter is more than 1.0 times the outer diameter of the fundus vein 21, the correction value obtained by subtracting 0.2 from the value of the V ratio is used as the arteriosclerosis. The total V ratio that should be used for detection of.
[0031]
3 is slightly different from the deviation of the fundus vein shown in FIG. 2, and in the intersecting fundus artery, there is an angle deviation between the distal center side and the center line in the length direction of the opposite fundus vein. Shows when there is. That is, in FIG. 3, in the fundus vein 22 crossing the fundus artery 12, the longitudinal center line 221 on the distal side of the fundus vein 12 and the longitudinal center line 222 on the opposite side are As shown in the figure, a shift angle is recognized rather than parallel. In this case, the deviation angle α is set to a distance of about 1/10 × ΦA from the crossing portion 33 opposite to the crossing portion 32 on the peripheral vein side, and the center in the length direction of each vein. It is defined as an angle that is recognized between the center lines in the length direction when the intersections of the lines are connected.
[0032]
Even in such a case, it is necessary to slightly correct the V ratio (V1 / V2) described above. Specifically, when a value obtained by multiplying the deviation angle α by 1/100 from the V ratio obtained above is an S value, a correction value obtained by subtracting the S value from the V ratio described above is obtained. The total V ratio to be used for detecting arteriosclerosis.
[0033]
  It should be noted that the deviation angle α to be subjected to such correction processing is preferably 10 ° (absolute value).more thanMore preferably, 5 ° (absolute value)more thanIt is. In this way, the software can determine the degree of stenosis of the fundus vein in the vicinity of the intersection of the fundus artery and fundus vein. In the following, unless otherwise specified, the total V ratio is assumed to include the uncorrected V ratio), and the calculated value and arteriosclerosis are calculated. It is one of the most preferable aspects of the present detection system that the means capable of detecting arteriosclerosis is provided in association with the degree of the above.
[0034]
In this detection system, a plurality of (two or more, usually two to three) computed values such as the total V ratio at the intersection of the fundus artery and the fundus vein that are separated from the nipple by one nipple diameter, For example, integrating as an average value and using this as a subject's total V ratio or the like as a detection index of arteriosclerosis is suitable for improving the reliability of the calculated value.
[0035]
In addition, the detection value obtained by executing the software algorithm may be an integrated value of calculation values obtained for different ECG signals. Since data can be extracted, it is easy. For example, the average value of the calculated values such as the total V ratio in the fundus image of the R wave and T wave of the electrocardiogram signal may be integrated, and this may be used as the detection index of arteriosclerosis as the total V ratio of the subject. This is suitable for improving the reliability of the operation value.
[0036]
  Furthermore, the standardization information obtained by standardizing the degree of stenosis of the fundus vein in the vicinity of the intersection of the fundus artery and the fundus vein, which is obtained by the total V ratio and the like, according to the age of a plurality of subjects, An algorithm that correlates the degree of stenosis in each subject by comparing the level of each other's value, etc. is installed in this software, and the organic changes in the morphology of blood vessels in the arteries of each subject It is also possible to detect the degree of arterial aging (in other words, blood vessel age) by functionally evaluating the blood vessel pulsation [for example, rather than the standardized information on the age and sex of the subject. The examiner's overall V ratio isIf smallThe subject's blood vessels are judged to have developed arteriosclerosis more than the standard, and the elderly as a functional assessment of the arterial blood vessel morphology and vascular pulsation, rather than the actual subject's age (In other words, the blood vessel age is evaluated as being higher than the actual age). Conversely, rather than the standardized information of the subject's age and gender, the subject's total V ratio isIf bigThe subject's blood vessels are judged to have not developed arteriosclerosis more than the standard, and are evaluated as being good as a functional evaluation of the arterial blood vessel morphology and blood vessel pulsation ( In other words, blood vessel age is evaluated as younger than actual age).
[0037]
In addition, it is one of the preferable aspects that this software is equipped with an algorithm capable of calculating the change rate of the operation value between different ECG signals.
[0038]
When this rate of change is obtained, it can be grasped in advance by obtaining the difference between the calculated values such as the total V ratio in the fundus image obtained in synchronization with two different types of electrocardiogram signals as target signals. Typically, it represents the difference between the total V ratio in the fundus image obtained in synchronization with the peak portion of the R wave, which is the most prominent timing, and the end portion of the T wave in the pulse wave cycle of the heart. A numerical value can be cited as an index of the change rate.
[0039]
Furthermore, as the rate of change of the overall V ratio, it is also effective to obtain the amount of change per unit time of the overall V ratio. That is, if the total V ratio is y, the first total V ratio measurement time is t, and the elapsed time until the next total V ratio measurement time is Δt, the total V ratio is expressed as y = f (t). The absolute value of the slope a of the linear function f (t) = at + b when the elapsed time Δt is reduced to such an extent that the function of the ratio y with respect to time t can be approximated to the linear function f (t) = at + b. It is also possible to use the numerical value to represent as the rate of change of the overall V ratio. In this case, if the rate of change is large, the blood vessel has elasticity, and if it is small, the blood vessel has no elasticity and is rigid. Such a change rate of the total V ratio can be used as one element for performing the functional evaluation of the vascular pulsation. In other words, if the elasticity of the blood vessel is recognized by the execution of such an algorithm, the functional evaluation of the arterial blood vessel structure and blood vessel pulsation is highly judged, and if the rigidity of the blood vessel is recognized, It becomes an element that the evaluation is judged low.
[0040]
In the present detection system, an arbitrary time can be set as the time t. However, the amount of change in the total V ratio per unit time is the same as that of the blood vessel pulse due to the wind Kessel phenomenon. It depends on the fluctuation period and is different within one period of this fluctuation period. That is, the selected time t is specified by an electrocardiogram signal synchronized with the fundus image, and the fundus image is made to depend on the electrocardiogram signal which is a reference of the fluctuation cycle of the vascular pulse, and the total V ratio in the fluctuation cycle of the vascular pulse. It is necessary to eliminate the measurement error due to the inherent difference in the amount of change in order to more accurately associate the change in the overall V ratio with the progress of arteriosclerosis. Therefore, even if the time t can be arbitrarily selected, it is necessary to select the time t depending on the electrocardiogram signal synchronized with the fundus image, and a typical wave signal of the electrocardiogram signal. It is preferable and realistic to set the time based on the R wave and T wave (the difference between the total V ratio synchronized with the peak portion of the R wave and the end portion of the T wave described above. Selects time t as the peak portion of the R wave and the end portion of the T wave, and sets the time Δt to the time taken from the peak portion of the R wave to the end portion of the T wave, or from the end portion of the T wave to R This is a value that is selected and calculated as the time it takes to reach the peak of the wave). The difference in the overall V ratio at this time Δt defines the rate of change in the pulsatility of the blood vessel that estimates the degree of arteriosclerosis.
[0041]
DETAILED DESCRIPTION OF THE INVENTION
Embodiments of the present invention will be described below.
FIG. 4 is a block diagram showing the configuration of the present detection system.
[0042]
The detection system 40 includes an electrocardiogram signal detection unit 41, a fundus image detection unit 43, and a computer 44.
This detection system 40 is a drawing showing one embodiment of an arteriosclerosis detection system of the present invention in which an electrocardiogram signal and a fundus image are synchronized in a computer 44.
[0043]
The electrocardiogram signal detection unit 41 includes an electrode sensor 411, an amplification unit 412, and an output unit 413. Further, the fundus image detection unit 43 includes a DV imaging unit 431 and an output unit 432.
[0044]
In the electrocardiogram signal detection unit 41, the electrode sensor 411 is formed of, for example, a piezoelectric element, and is a mechanism that detects an electrocardiogram signal that is attached to and is derived from the chest or other living body of the subject. The amplification unit 412 The electrocardiogram signal detected by the electrode sensor 411 is amplified, and the output unit 413 is a mechanism that outputs the amplified electrocardiogram signal.
[0045]
In this detection system 40, in order to perform synchronization processing in the computer 44, an electrocardiogram signal is directly input from the output unit 413 of the electrocardiogram signal detection unit 41 to the input unit 441 of the computer 44. It is preferable that the digitization processing is performed by an A / D converter (414) or the like.
[0046]
The fundus image detection unit 43 captures the fundus image of the subject using a DV imaging unit (imaging unit of a digital video camera), extracts a video signal of the fundus image obtained thereby, A signal is input from the output unit 432 to the computer 44 via the DV terminal and from the input unit 442 via a DV capture card or the like. Note that the digital video camera of the DV imaging unit 431 preferably has a resolution as high as possible in order to measure a subtle change in the fundus vein diameter. Specifically, it is preferable to have a resolution of 2 million pixels or more. Further, the DV imaging unit 431 includes a mechanism for imaging the fundus of the subject, such as an eyepiece lens, a light source, an alignment mechanism, and an angle-of-view adjustment mechanism, which is included in a normal fundus camera, as necessary. Of course, it has.
[0047]
The digital image signal of the fundus image input to the computer 44 is combined with the image signal of the video image of the fundus image input from the input unit 441 in the processing unit 443 of the computer 44, so that the fundus image The moving image data and the electrocardiogram signal are synchronized every same frame (synchronization processing 4431), and the fundus image moving image data and the electrocardiogram signal digital synchronization data (4432) can be obtained. The synchronization data 4432 may be subjected to processing such as compression as necessary.
[0048]
At this time, the digitized electrocardiogram signal and / or the digital image signal of the fundus image are displayed as an electrocardiogram and / or fundus image on the display means of the computer 44 through processes such as inverse quantization and interpolation. It is preferable that output can be performed.
[0049]
As described above, the synchronization data 4432 can be used as it is in subsequent steps such as measurement of the fundus venous diameter, and can be temporarily stored in an electronic medium.
[0050]
In the basic data measurement step 4433, based on the synchronization data 4432, at least one intersection of the fundus vein and the fundus artery is selected as a target site, and the blood vessels of the fundus artery and the fundus vein in the target site are selected. This is a step of measuring basic data for determining arteriosclerosis such as diameter.
[0051]
These basic data are preferably measured at different timings in each target region. This different timing can be freely set as a minimum timing that a change in data such as a blood vessel diameter to be obtained can be detected.
[0052]
In the analysis step 4434, the basic data is obtained by performing appropriate analysis based on the basic data such as the blood vessel diameter of the intersection of the fundus artery and the fundus vein, which is the target site, measured in the basic data measurement step 4433. Can be converted into more useful information. This useful information includes, for example, the above-described total V ratio, blood vessel age, and the like of the subject.
[0053]
In addition, when basic data was measured at different timings, it was dependent on the electrocardiogram signal by measuring changes in the fundus vein diameter by measuring changes in the overall V ratio between timings at each target site. It is useful to calculate changes such as the total V ratio per unit time. That is, as described above, by measuring this change, it is possible to calculate the degree of organic change in the blood vessel of the subject and the degree of flexibility of the artery.
[0054]
In this manner, in the present detection system 40, it is possible to continuously obtain a fundus image synchronized with an electrocardiogram signal obtained by the computer 44, that is, a stable fundus image not affected by the wind Kessel phenomenon, As a result, it is possible to improve the reliability of the obtained overall V ratio, etc. by sampling a large amount of data that is an index of arteriosclerosis, such as the overall V ratio, and calculating these integrated values. Furthermore, it is possible to easily obtain an index relating to the organic changes in the blood vessels of the subject and the flexibility of the artery.
[0055]
FIGS. 5 (1) to (12) are drawings showing an embodiment (400) of the flow sheet of the software used in the processing device of the computer 44 of the detection system 40. FIG. In this embodiment, the operation of the computer 44 in each process is preferably a mouse operation as necessary (in this example, an example is shown by displaying “mouse operation”).
[0056]
In FIG. 5 (1), 0000 “start” indicates that the computer 44 is set up in a state where the software for performing the processing shown in the flow sheet 400 can be executed. After the setup, the initial menu screen is called (0001), and video output is performed on the display means of the computer 44, for example, an operation menu such as “registration, correction, display, aggregation, end” is displayed (0002).
[0057]
Next, an initial menu is selected (0003). In this initial menu selection step (0004), for example, when “registration” is selected and initial data is input, an “initial data input screen” is displayed (0005). When “Display” is selected, “Data Confirmation Display Screen” is displayed (0006), and when “Total” is selected, “Data Total Screen” is displayed (0007) [“Display” or “Total” Process (d) (e) after selection will be described later. Further, when “correction” is selected, a correction menu for data correction is displayed, and when “end” is selected, execution of the program ends after execution of the end confirmation process.
[0058]
After displaying the image on the initial data input screen (0008/0009), input the initial data (medical chart number, name, gender, age, blood pressure level, cholesterol level, blood glucose level, etc.) from the keyboard, etc. (0010). Is completed (0011).
[0059]
Next, the fundus image photographing preparation process will be described. When photographing a fundus image, first, a preparation for photographing is performed in the fundus image detection unit 443 (0100), and an electrocardiogram signal input from the input unit 441 to the computer 44 is confirmed on the display means of the computer 44 (0101). ).
[0060]
After the end of the electrocardiogram confirmation (0102), an imaging condition selection screen is displayed (0103), the fundus image detection field angle (50 ° or 25 °) is selected by the fundus image detection unit 43, and the detection unit 43 is detected. Then, shooting conditions corresponding to the selected shooting angle of view are set (0105, 0106).
[0061]
When a shooting field angle of 50 ° is selected in step 0106 (imaging process A), the fundus image detection unit 43 captures the fundus at an angle of view of 50 ° (0200), and digital data of the image passes through the input unit 442. The image is input to the computer 44, and the video output display is performed on the display means (0201, 0202). By digitally combining the input digital data of the fundus image and the electrocardiogram signal, the moving image data of the fundus image and the electrocardiogram signal are synchronized every same frame, so that the moving image data of the fundus image and the electrocardiogram signal are digitally synchronized. Data can be obtained. After the completion of the imaging process A, it is possible to return to the imaging condition selection display process (0103) again, and the imaging process A can be performed a plurality of times as necessary. Further, after the completion of the imaging process A, it is possible to shift to a process (imaging process B) including an imaging process at an imaging angle of view of 25 ° in order to obtain an enlarged screen of a specific part.
[0062]
FIGS. 5 (2) and 5 (3) show a part including the imaging process at the imaging angle of view of 25 °. First, from a fundus image at an imaging angle of view of 50 °, for example, three points are selected for candidate portions of arteriosclerosis (0203), and each point is selected (for example, each point is designated as A point, B point, and When selecting this point, video is output and, for example, each point is displayed with a cross (0204, 0205) After each point is selected, each point at this imaging angle of view of 50 ° is displayed. The imaging data synchronized with a specific electrocardiogram signal is saved (0207, 0208) In this saving, for example, it is preferable to save the initial data such as the above-described chart number and blood pressure value together with the imaging data. is there.
[0063]
Next, in order to perform the analysis process of the A point selected as described above, the fundus image is displayed at the above-mentioned imaging angle of view of 50 ° (0209, 0210), and the vicinity of the A point is again displayed at the angle of view of 25 °. (0211), a mouse operation for selecting an arteriosclerotic portion at point A is performed (0212), and a portion recognized as an arteriosclerotic portion is again imaged at an imaging angle of view of 25 ° (0213). The video of the A point related to this shooting is output (0214), and the video data is saved (0215 to 0217).
[0064]
Next, the process of outputting and storing the fundus image at the angle of view of 25 points of the B point and the C point is performed in the same procedure as the case of the A point (B point: 0218 to 0227, C point: 0228 to 0237).
[0065]
Next, a process related to the measurement of the outer diameter of the fundus vein will be described [FIG. 5 (3)]. First, the point selection screen is displayed (0238). Specifically, video output of the point selection screen is performed (0239), and in this example, a measurement point is selected from the given points A point, B point, and C point (0240). When the A point is selected (0241), the A point portion is displayed from the measurement screen by operating the mouse (0242, 0243), and the arteriosclerotic portion is enlarged by operating the mouse (0244). Video output is performed (0245 to 0247).
[0066]
Next, the process proceeds to a step of measuring the outer diameter of the fundus artery [FIG. 5 (4): Specifically, only the A point is described, but the same step can be performed for the B point and the C point. it can〕.
[0067]
The outer diameter measurement step (0248) of the fundus artery is performed by displaying the enlarged portion of the A point and dragging the outer diameter of the target fundus artery 10 with the mouse (0249). The measured value is displayed by setting the measured value of the diameter of the fundus artery 10 as A1 (0250), 1/10 of the outer diameter of the artery A1 as 1 / 10A1 (0251). Again, the image of the part is output (0253), and the outer diameter of the fundus artery 10 on the peripheral side of the fundus artery 10 is clicked at the intersection of the fundus artery and the fundus vein (0255). Next, from this portion, a position and a numerical value that are separated by 1 / 10A1 to the distal side of the fundus vein are displayed (0256), and video output is performed (0257).
[0068]
Next, the process proceeds to the outer diameter measuring step (0259) of the first fundus vein. After the video output (0257), the fundus vein diameter (V1) at a position 1 / 10A1 away from the peripheral side is further measured by dragging with the mouse, and the value of V1 is measured. Is output while video is displayed (0260 to 0264).
[0069]
The process proceeds to the peripheral fundus vein diameter measurement step (0265) at a position further away from the fundus artery than the position separated by 1 / 10A1. First, the outer diameter on the distal side of the fundus vein of the fundus artery at the intersection of the fundus artery and fundus vein is clicked (0266). Further, a distance three times as large as the fundus artery diameter A1 is calculated, and this is set to A2, and the position and number of the distal side A2 of the fundus vein are displayed, and video output is performed (0267 to 0270).
[0070]
Next, the process proceeds to a process (0271) for measuring the outer diameter of the second fundus vein. After the video output, the diameter of the fundus vein (V2) at a position away from the peripheral side by A2 is further measured by dragging with the mouse [FIG. 5 (5) 0272, 0273), while displaying the value of V2 (0274), video output is performed (0275).
[0071]
Next, the process proceeds to the V ratio calculation process (0300). That is, based on the values of V1 and V2 obtained as described above, V1 / V2 is calculated as a V ratio (0301), and this video is displayed (0302, 0303), and the V ratio is represented by data. (0303 to 0306).
[0072]
Next, the process proceeds to the measurement process (0401) of the center line on the peripheral side of the fundus vein. In this step, first, V1 is clicked to call that value (0402,0403), and X1 which is a value obtained by multiplying this value by 1/2 is calculated (0405). Next, based on the calculated X1, video output of the midpoint (X1) of the line segment obtained by dragging V1 is performed (0406, 0407). Further, V2 is clicked to call the value (0408, 0409), and X2 that is a value obtained by multiplying this value by 1/2 is calculated (0410, 0411). Next, based on the calculated X2, video output of the midpoint (X2) of the line segment obtained by dragging V2 is performed (0412, 0413). Finally, the vector line X1X2 connecting the center points X1 and X2 is displayed (0414), and video output is performed (0415).
[0073]
Next, the process proceeds to the measurement process (0416) of the center line on the opposite side to the peripheral side of the fundus vein. This step is performed in a procedure substantially similar to the procedure in the above-described fundus vein centerline measurement process (0401).
[0074]
First, at the intersection of the fundus artery and the fundus vein at point A, the outer diameter of the fundus artery opposite to the distal side of the fundus vein is clicked (FIG. 5 (6) 0417). Next, from this outer diameter, a position and a numerical value that are separated by 1 / 10A1 from the distal side of the fundus vein to the distal side are displayed (0418, 0419), and video output is performed (0420).
[0075]
Next, by operating the mouse, the fundus vein diameter (V3) at a position 1 / 10A1 away from the opposite side of the peripheral side is measured by dragging with the mouse (0421, 0422), and the value of V3 is determined. The video is output while displaying (0423, 0424). Further, in order to measure the center of V3 (0425), V3 is clicked to call the value (0426, 0427), and Y1 which is a value obtained by multiplying this value by 1/2 is calculated (0428). Next, based on the calculated Y1, video output of the midpoint (Y1) of the line segment obtained by dragging V3 is performed (0429, 0430).
[0076]
Next, a position (A4) separated from the peripheral side by A2 is displayed by mouse operation (A4, 0432), and the fundus vein diameter (V4) at A4 is measured (0435). That is, by dragging with the mouse, V4 is measured (0436, 0437), and video output is performed while displaying the value of V4 (0438, 0439). Further, V4 is clicked to call the value (0440, 0441), and Y2 which is a value obtained by multiplying this value by 1/2 is calculated (0442). Next, based on the calculated Y2, the video output of the midpoint (Y2) of the line segment obtained by dragging V4 is performed (0443). Finally, the vector line Y1Y2 connecting the center points Y1 and Y2 is displayed and video output is performed [FIG. 5 (7) 0444, 0445].
[0077]
The vector lines X1X2 and Y1Y2 obtained as described above are stored and stored as data (0446-0448).
Next, the process proceeds to a fundus vein deviation measurement process for calculating the total V ratio.
[0078]
First, an average distance between the vector lines X1X2 and Y1Y2 is calculated, and this value is set as XY1 (0500) and divided by the fundus vein diameter (average value of V4 and V2: V5), that is, XY1 / V5 = XY1a. Are calculated (0501) and stored (0502, 0503).
[0079]
Next, the process proceeds to a measurement process (0600) of the deviation angle of the fundus vein. “Angle measurement” is selected from the menu and clicked (0601), and by operating the mouse, X1 and Y1 are connected (0602, 0603), and video output of this vector line X1Y1 is performed (0604, 0605). In order to determine the displacement of the peripheral vein (0606), again select and click "angle measurement" from the menu (0607), click the vector line Y1Y2 as the reference line for the displacement angle measurement (0608), mouse The vector line X1Y1 is designated by the operation (0609, 0610), and the angle (absolute value) between the vector lines Y1Y2 and X1Y1 is measured (0611).
[0080]
In step 612, when the deviation angle (absolute value) is 5 ° or more (YES), the process proceeds to a process of determining the total V ratio (deviation angle correction process) using the deviation angle as a correction factor.
[0081]
In the deviation angle correction process, the angle of the vector lines Y1Y2 and X1Y1 measured in the above-described angle measurement process is converted into an appropriate numerical value (S value) as a V ratio correction parameter, and this value is used as the V ratio. Is a process for determining the total V ratio (0700). First, the measurement angle / 100 is calculated [FIG. 5 (8) 0701]. For example, if the measurement angle is 10 °, the S value is 0.1, and if it is 15 °, it is 0.15. Next, a value obtained by subtracting the S value from the V ratio is calculated as an “total V ratio” (0702), and a video output display of the measurement angle, the S value, and the total V ratio is performed (0703, 0704). Is stored (0705), a mouse operation (0706) is performed and data such as a measurement angle is stored (0707).
[0082]
Here, it is possible to display a list of measurement data obtained by the previous measurements (0708). In other words, when "Display measurement data" is clicked by operating the mouse (0709, 0710), it is the same as the A point including the V1 value, V2 value, V ratio, total V ratio, and other measurement data of the above A point. These measurement data at the B point and C point obtained by the above process are displayed in a list (0711-0712). In this way, the shift angle correction process can be performed. After the deviation angle correction process is completed, the process proceeds to a “comparison / determination process between standardized information and the measured total V ratio” described later [Process (A)].
[0083]
Next, in step 612, when the misalignment angle is less than 5 ° (NO), the process proceeds to process (A), and the following process for determining the overall V ratio (deviation correction process) is performed.
[0084]
The shift correction process shifts to a comprehensive V ratio determination process (0800) in which a correction value in the V ratio is calculated based on XY1a calculated in step 0501 and the V ratio is corrected as the total V ratio. .
[0085]
First, steps 0801 and 0802 are steps for selecting whether or not XY1a is 0.5 or more. If NO, that is, if XY1a is less than 0.5, the correction value is 0, and in step 0301 The calculated V ratio is stored as data [process (c)]. On the other hand, in the case of YES, that is, when XY1a is 0.5 or more, the process proceeds to a step (0803, 0804) for determining whether or not XY1a is 1.0 or more. When this step is NO, that is, when XY1a is less than 0.5 to 1.0, the correction value is −0.1, and a value obtained by subtracting 0.1 from the V ratio calculated in step 0301 ( V11: 0808) is a value that more accurately corresponds to the degree of progression to arteriosclerosis, and this value is stored and stored as the total V ratio V11 (V22: 0809, 0810). When this step is YES, that is, when XY1a is 1.0 or more, the correction value is −0.2, and the value (0805) obtained by subtracting 0.2 from the V ratio calculated in step 0301 is It is a value that more accurately corresponds to the degree of progress in arteriosclerosis, and this value is stored and stored as the overall V ratio V22 (0806, 0807). In this way, the deviation correction process can be performed. After the deviation correction process is completed, the process proceeds to a “comparison determination process between standardized information and measurement total V ratio” described later.
[0086]
  Next, the comparison judgment process [FIG. 5 (9) 0900] between the standardized information and the measurement total V ratio will be described. The standardized information (standard total V ratio value corresponding to age) (0902) input as data in advance (0902) is compared with the measured total V ratio information (0901) measured above (0903). That is, step 0904 is a step of comparing the size of the standardized information and the measured total V ratio information. In this step, NO, that is, the measured total V ratio information is more than the standardized information.largeIn this case, the blood vessel age younger than the actual age of the subject is detected (0907), and this is stored as the blood vessel age B (0908, 0909). On the other hand, in step 0904, YES, that is, whether the standardized information and the measured total V ratio information are the same, or the measured total V ratio information is more than the standardized information.smallIn this case, the age of the blood vessel that is the same as or older than the actual age of the subject is detected (0905), and this is stored as the blood vessel age A (0906, 0910).
[0087]
Next, the process proceeds to the blood vessel flexibility measurement process (1000). In this process, the total V ratio obtained from the fundus image synchronized at the peak of the R wave and the total V ratio obtained from the fundus image synchronized at the end of the T wave are measured and compared. This is a step of measuring the flexibility of the blood vessel.
[0088]
  First, the fundus image synchronized with the peak of the R wave of the electrocardiogram signal is displayed (1001). That is, a mouse operation (1002) outputs a fundus image (shooting angle of view 50 °) synchronized at the peak of the R wave (1003 to 1006), and selects a measurement screen (1007). As described above, here, the A point is selected (1008). That is, the A point portion is displayed by the mouse operation (1009) (1010), and an image of the enlarged arteriosclerotic portion is output (imaging angle of view 25 °) [FIG. 5 (10) 1011 1014]. Then, atherosclerotic partFundus arteryThe outer diameter (AMX2) of 10 is measured by dragging with the mouse, and the measured value is output as an image (1015 to 1019).
[0089]
  Further, the fundus image synchronized with the end of the T wave of the electrocardiogram signal is displayed (1020). That is, the mouse operation (1021) outputs the image of the fundus image (shooting angle of view 50 °) synchronized at the end of the T wave of the electrocardiogram signal (1022 to 1025), and selects the measurement screen (1026). . As described above, the A point is selected (1027). That is, the A point portion is displayed by the mouse operation (1028) (1029), and further, the video output of the enlarged image of the arteriosclerotic portion is performed (imaging angle of view 25 °) (1030 to 1033). Then, atherosclerotic partFundus arteryAn outer diameter (AMN2) of 10 is measured by dragging with a mouse, and an image of the measured value is output [FIG. 5 (11) 1034 to 1038].
[0090]
Next, the difference (FX ratio) between AMX2 and AMN2 obtained in these processes is obtained (1039). This FX ratio can be used as an index indicating the elasticity of blood vessels. Finally, the numerical value of the FX ratio and the image associated therewith are stored (1040, 1041).
[0091]
Thus, one embodiment of the subject's arteriosclerosis detection process by the detection system 40 ends (1042).
Data confirmation display process
The data confirmation process (2000) when “display” is selected in the above-described flow sheet initial menu selection step (0004) will be described.
[0092]
In the initial menu selection step (0004), when “display” is selected and the process (D) is entered, a keyboard input screen appears (2001), and when the subject ID number is entered by the keyboard (2002), Each data of the subject is output as a video (2003). Here, the process proceeds to a step of confirming and determining the contents of each data of the subject subject (2004). In the determination step 2005, NO, that is, if there is an error in the contents of each data of the subject subject, there is a need for correction, the keyboard input of the correction information is performed on the keyboard input screen, The above process is repeated [repeated process (a)]. On the other hand, if YES, the content of each data of the subject is not required to be corrected, video output of each point (A point, B point, C point) is made (2006, 2007) ) Each point is displayed on the screen. From these points, a desired point screen is selected and clicked (2008, 2009), and the video output display of the enlarged screen is performed by the mouse operation (2011) (2011), and the enlarged screen and various data are displayed. [FIG. 5 (12) 2012], the data confirmation display step ends.
[0093]
Data list display process
The process (3000) of displaying a list of data when “total” is selected in the above-described initial menu selection step (0004) of the flow sheet will be described.
[0094]
In the initial menu selection step (0004), when “total” is selected and the process proceeds to process (e) (3001), a data display screen appears and a menu for data totalization appears. When a desired tabulation form is selected from these menus (3002), video output of a list display rearranged by each numerical item is performed (3003). Such data list display is performed, and the data list display step is completed.
[0095]
【The invention's effect】
The present invention provides a simple and sensitive means for detecting arteriosclerosis.
[Brief description of the drawings]
FIG. 1 is a schematic diagram of a fundus artery and a fundus vein in which a stenosis of the fundus vein is observed.
FIG. 2 is a schematic diagram showing a case where the hardening of the vascular intima of the fundus artery spreads in a direction slightly shifted from the intersection.
FIG. 3 is a schematic diagram showing a case where a shift angle is recognized in the fundus vein at the intersection of the fundus artery and the fundus vein.
FIG. 4 is a block diagram showing a configuration of the present detection system.
FIG. 5 is the first of the drawings showing an embodiment of the flow sheet of the software used in the computer processing apparatus of the detection system.
FIG. 6 is the second of the drawings showing an example of the flow sheet of the software used in the computer processing apparatus of the detection system.
FIG. 7 is the third drawing showing an example of the flow sheet of the software used in the computer processing apparatus of the detection system.
FIG. 8 is the fourth drawing showing an embodiment of the flow sheet of the software used in the computer processing apparatus of the detection system;
FIG. 9 is a fifth drawing showing an example of the flow sheet of the software used in the computer processing apparatus of the detection system;
FIG. 10 is the sixth drawing showing an example of the flow sheet of the software used in the computer processing apparatus of the detection system;
FIG. 11 is the seventh drawing showing an example of the flow sheet of the software used in the computer processing apparatus of the detection system;
FIG. 12 is the eighth drawing showing an example of the flow sheet of the software used in the computer processing apparatus of the detection system;
FIG. 13 is the ninth drawing showing an example of the flow sheet of the software used in the computer processing apparatus of the detection system;
FIG. 14 is the tenth drawing showing an example of the flow sheet of the software used in the computer processing apparatus of the detection system.
FIG. 15 is the eleventh drawing showing an embodiment of the software flow sheet used in the computer processor of the detection system.
FIG. 16 is the twelfth figure showing an embodiment of the flow sheet of the software used in the computer processing apparatus of the detection system.
[Explanation of symbols]
40: This detection system
41: ECG signal detector
43: Fundus image detection unit
44: Computer

Claims (8)

In an arteriosclerosis detection system comprising an electrocardiogram signal detection means and a fundus image detection means capable of detecting a fundus image synchronized with the electrocardiogram signal detected thereby, the fundus image is detected from a moving image of the fundus image. This is a detection system for arteriosclerosis performed by software that can provide a fundus image synchronized with an electrocardiogram signal by extracting a still image of the fundus synchronized with an arbitrary electrocardiogram signal on a computer display screen. The software calculates the degree of stenosis of the fundus vein in the vicinity of the intersection of the fundus artery and fundus vein with respect to different ECG signals, and calculates the integrated value of these calculated values and the degree of arteriosclerosis. A system for detecting arteriosclerosis, which is software associated with a means capable of detecting arteriosclerosis. In the arteriosclerosis detection system, a calculation value obtained by software capable of providing a fundus image synchronized with an electrocardiogram signal is obtained from a fundus image near the intersection of two or more fundus arteries and fundus veins. The arteriosclerosis detection system according to claim 1, which is an integrated value. The software capable of providing a fundus image synchronized with an electrocardiogram signal in the arteriosclerosis detection system is provided with means capable of calculating a rate of change of a calculation value between different electrocardiogram signals. The detection system for arteriosclerosis according to 1 or 2. In the arteriosclerosis detection system, software capable of providing a fundus image synchronized with an electrocardiogram signal is associated with a means capable of detecting arteriosclerosis by associating the change rate of the calculated value with the degree of arterial flexibility. The detection system for arteriosclerosis according to claim 3. In the arteriosclerosis detection system, software capable of providing a fundus image synchronized with an electrocardiogram signal is synchronized with an arbitrary ECG signal while simultaneously displaying a fundus image and a moving image of the electrocardiogram on the display means in the computer terminal. The system for detecting arteriosclerosis according to any one of claims 1 to 4, which is software capable of extracting a fundus image that has been obtained. The arteriosclerosis detection system according to any one of claims 1 to 5, wherein in the arteriosclerosis detection system, an arbitrary electrocardiogram signal includes a signal indicating an R wave and / or a T wave of the electrocardiogram signal. The electronic medium in which the software used in order to perform the detection system of arteriosclerosis in any one of Claims 1-6 was stored. Software used to perform the arteriosclerosis detection system according to any one of claims 1 to 6.