RU2367340C2 - Capillary blood flowrecorder - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine. Said apparatus comprises a body with an in-built optical system, a finger holder, a light system that generates a focused light spot. The optical system is provided with a channel for digital camera connection, monitoring and PC capturing. The light system comprises a set of light-emitting diodes, each been equipped with a focusing lens, while fixed around the periphery of a hollow protection enclosure and concentrically angularly equispaced around the axis of the optical system and inclined thereto at the angle 45°±10°.

EFFECT: application of the present apparatus provides the best-known conditions of balanced shadow-free illumination of capillaries and image contrast with any capillary arrangement.

14 cl, 2 dwg

Description

The invention relates to optics, specifically to stereomicroscopes, creating illumination for phase contrast monitoring and having more than one path of a light beam, namely, devices that are designed to register capillaroscopic pictures, and can be used to measure the speed of capillary blood flow, as well as determine the magnitude, specific gravity, shape, caliber of the nail vessels in the diagnosis, which is based on the study of capillaries. The device can be used in neurology, neurosurgery, traumatology, vascular surgery, cardiology, anesthesia and resuscitation, general therapy.

Known stereo microscope with a smooth variable magnification, which is used to study capillaries. This stereo microscope is equipped with a halogen lamp with a power of up to 150 W and an optical fiber bundle to bring optical radiation into the plane of the microscope. To monitor capillaries, an analogue television camera installed on it with a television monitor connected to a computer is used (see Nailfold Capillaroscopic Monitoring as Preventive Medicine in Subjects Exposed to Ionising Radiation. R. Pennarola, B. Perdereau, G. Trenta, J.M. Cosset).

The disadvantage of such a capillaroscope is the use of universal illuminators for stereo microscopes, which, having a complex structure and high price, do not provide the best conditions for observing capillaries due to unidirectional oblique lighting.

The closest analogue is a device for recording capillary blood flow, consisting of a housing in which an optical system is installed, a finger clip, a lighting system that creates a focused light spot, a signal processing unit, and the optical system has a digital channel for connecting a digital camera and observing and recording images on the computer. The lighting system is made in the form of an LED lamp, which is located on the side at a certain angle to the axis of the optical system and creates oblique lighting (see Ukrainian patent No. 67709, IPC G02B 21/36, G02B 21/00, 2004).

The disadvantages of such a capillaroscope design include one-sided side illumination, which leads to the appearance of shadows, as a result of which the shape and size of the capillary images will depend on their orientation relative to the direction of illumination. The use of an optical oblique illumination scheme is best for observing capillaries located perpendicular to the plane in which the axes of the optical system and illuminator lie. If the capillary is located in this plane, then the contrast of its image will be less, since it is illuminated at an angle. Shadow effects in oblique lighting are also possible.

The basis of the invention is the task of creating such a device for recording capillary blood flow, in which by changing the design of the illuminator and its location, the best conditions for uniform shadowless illumination of the capillaries are provided. This provides the opportunity to achieve the best image contrast at any location of the capillaries.

To solve the problem, a device has been proposed for recording capillary blood flow, consisting of a housing in which an optical system is installed, a finger clip, a lighting system that creates a focused light spot, and the optical system has a channel for connecting a digital camera and observing and fixing the image on a computer, which according to the invention the lighting system is made in the form of a set of LEDs, each of which is equipped with a focusing lens, which are fixed around the perimeter of the hollow protectively of the housing and concentrically arranged with equal angular increments around the optical axis and inclined thereto at an angle of 45 ° ± 10 °.

With this embodiment of the illuminator, the intersection point of these axes and the optical axis of the stereo microscope coincides with the intersection point of the optical axis and the plane of the object under study. This provides illumination intermediate between the illumination of light and dark fields. As a result, the beam reflected from the capillaries predominantly enters the stereomicroscope lens, and the majority of the beam reflected from the skin surface passes by the lens. At large angles, a part of the flux of optical radiation entering the micro-lens decreases. And for smaller ones, a part of the flow reflected from the oil on the skin surface increases, which is an obstacle when observing capillaries. An important advantage of such lighting is that instead of unidirectional oblique lighting, circular oblique lighting is used. Because of this, the contrast of the image of the capillary will not depend on its orientation in the plane of objects.

Depending on the lighting needs, the number of LEDs can be from 3 to 24 pieces.

In an optimal embodiment, a protective casing is installed in the lower part of the body of the optical system. For reliable protection of the doctor and patient from radiation and heating of the illuminator, as well as to avoid extraneous light reflections, the casing is painted black.

In order to be able to control the distance between the fixative and the optical system (for different objects of study, for example, nails of the feet or hands), and also for ease of transportation, the case with the optical and lighting systems is mounted on a tripod with the possibility of moving along it.

For the convenience of pointing the optical system to the object of study, the device is additionally equipped with two eyepieces.

In order to be able to quickly change the field of view to simplify the search and detailed observation of capillaries, a stereo microscope with variable magnification is used as an optical system.

The latch may have a light-absorbing screen to reduce reflections that enter the lens from objects outside the field of view.

Using the proposed device, in which a system of LEDs is used as a illuminator, each of which has a focusing lens that focuses its flow on the skin surface, allows to obtain high-quality images of capillaries under the skin. Powerful (super-bright) LEDs provide backlighting with white light, which allows to obtain high-quality color images of capillaries; possible use of high-power (super-bright) LEDs in the blue and ultraviolet ranges for observing capillary fluorescence. The location of the diodes provides the best conditions for uniform illumination of capillaries and shadowless illumination.

Figure 1 shows a schematic diagram of the proposed device.

Figure 2 shows the LED with a lens.

The device for recording capillary blood flow consists of a housing 1, in which an optical system 2 is installed, which provides an increase in the image of the capillary picture and the focal area of which is on the illuminated part of the nail bed, which is lubricated with camphor oil, the fixative 3 for the finger, made in the form of a plate with a recess in the shape of the fingers, the lighting system 4, creating a focused light spot on the nail bed of the patient’s finger. The optical system has a channel 5 for connecting a digital camera 6 and observing and fixing the image on the computer 7. The lighting system 4 is made in the form of a set of LEDs 8, each of which is equipped with a focusing lens 9, which are fixed around the perimeter of the hollow protective casing 10, placed concentrically with equal angular pitch around the axis of the optical system and inclined to it at an angle of 45 ° ± 10 °. The housing 1 with optical 2 and lighting 4 systems is mounted on a tripod 11 with the ability to move along it. The device is equipped with two eyepieces 12.

The device operates as follows.

The patient sits near the table in a free pose, without tension. The brush should be at the level of the heart. The forearm and palm are placed on a soft but firm support on the stage. The fingers are placed on the table, and the finger selected for the study is placed on the latch 3 under the lens of the optical system 2 (stereo microscope). The hand of the subject should be freed from rings, bracelets, tight clothing. A drop of camphor oil is applied to the study area. The temperature of the table and the bed for the finger should be at least 27 ° C.

The light from the light source is focused on the eponychium 4. The capillaries of the nail bed are placed in the focus of the optical system 2 to obtain a clear image on the monitor. First, you need to conduct a survey study with an increase of x 400, which will give an idea of the number of capillaries per unit surface, the degree of their tortuosity and variability. For measurements, select areas with good visualization. The adjustment and selection of capillary loops are carried out directly from the image displayed on the monitor screen.

The study evaluates visually the density of capillary distribution, their shape (degree of tortuosity), the presence of anastomoses, the number of aggregates of blood cells.

Processing of primary information in order to obtain data on capillary blood flow is carried out using specially developed software.

The proposed device makes it possible to study the capillaries of the nail bed in reflected light, increasing the image by more than 80 times. It is equipped with a lighting system, with which the skin of the nail roller is illuminated by focused light. Special optics transfers the resulting image to the CCD matrix of the color video camera, the signal from which is fed to the video editing complex, and then to the PC. Thus, we can not only visually observe the capillary picture of the nail bed in the eyepiece, but also take advantage of all the advantages of software processing computer visualization.

This system works on the basis of the electron-optical method, which makes it possible to create folded optical radiation on the finger of the subject. The light spot is placed in the focus of the magnifying optical system, which captures the capillary blood flow, and then, on the basis of software processing and visual analysis of the resulting video image, we obtain qualitative and quantitative characteristics of the capillary blood flow.

Regular capillaroscopic examination makes it possible to diagnose microcirculatory disorders, non-invasively monitor the effectiveness of antiplatelet therapy in patients with coronary heart disease, diabetes mellitus, etc., as well as to study the dynamics of reactions of microstructures and materials.

Computer processing of capillaroscopic studies provides:

- the ability to visualize microcirculatory changes in capillary blood flow on a computer monitor screen;

- archiving in the database of images of capillary blood flow, as well as their revision in an arbitrary order;

- enhancing image contrast;

- measuring the size of capillaries, the number of aggregates of blood cells;

- conducting an observation in the dynamics of capillary blood flow with an increase of 100 times;

- prediction of pre-stroke and pre-infarction conditions of patients.

Claims (14)

1. A device for recording capillary blood flow, consisting of a housing in which an optical system is installed, a finger clip, a lighting system that creates a focused light spot, the optical system having a channel for connecting a digital camera and observing and fixing an image on a computer, characterized in that the lighting system is made in the form of a set of LEDs, each of which is equipped with a focusing lens, which are fixed around the perimeter of the hollow protective casing, and are placed concentrically with avnym angular pitch about the axis of the optical system and inclined thereto at an angle of 45 ° ± 10 °. 2. The device according to claim 1, characterized in that the number of LEDs is 3-24 pieces. 3. The device according to claim 1, characterized in that the protective casing is installed in the lower part of the body of the optical system and is painted black. 4. The device according to any one of claims 1 to 3, characterized in that the housing with optical and lighting systems is mounted on a tripod with the ability to move along it. 5. The device according to 4, characterized in that it is additionally equipped with two eyepieces. 6. The device according to any one of claims 1 to 3, characterized in that a stereo microscope is used as an optical system. 7. The device according to claim 4, characterized in that a stereo microscope is used as an optical system. 8. The device according to claim 5, characterized in that a stereo microscope is used as an optical system. 9. The device according to any one of claims 1 to 3, characterized in that the latch has a light-absorbing screen. 10. The device according to claim 4, characterized in that the latch has a light-absorbing screen. 11. The device according to claim 5, characterized in that the latch has a light-absorbing screen. 12. The device according to claim 6, characterized in that the latch has a light-absorbing screen. 13. The device according to claim 7, characterized in that the latch has a light-absorbing screen. 14. The device according to claim 8, characterized in that the latch has a light-absorbing screen.

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