Apparatus and method of processing tomographic data.

专利摘要:
An apparatus and method (100) for processing data (501) obtained by means of an imaging method make it possible to improve a site-specific visualization of the perfusion of the lungs. By referring to a comparison quantity, a location-specific variable (503) characteristic of a viewing period with regard to the perfusion of lung and heart region is determined and provided as an output signal.
公开号:CH709834B1
申请号:CH00893/15
申请日:2015-06-22
公开日:2016-06-30
发明作者:Leonhardt Steffen；Baier-Löwenstein Tim；Mersmann Stefan；Pikkemaat Robert；Teschner Eckhard
申请人:Drägerwerk Ag & Co Kgaa；
IPC主号:

专利说明:

Apparatus and method for processing tomographic data
The present invention relates to an apparatus and a method for processing and visualizing obtained by means of a suitable for generating data for imaging medical device data regarding perfusion (perfusion) and ventilation (ventilation) of the lung or areas of the lung, as well for the circulation of the heart.
Devices for electro-impedance tomography (EIT) are known from the prior art. These devices are designed and intended to generate an image, a plurality of images or a continuous image sequence from signals obtained by means of electro-impedance measurements and from data and data streams obtained therefrom. These images or sequences of images show differences in the conductivity of various body tissues, bones, skin and body fluids (blood, lymph, cerebrospinal fluid) and organs (lungs, heart), which are useful for diagnosing diseases and pathologies.
Thus, US Pat. No. 6,236,886 describes an electrical impedance tomograph with an arrangement of several electrodes, current supply to at least two electrodes and a method with an image reconstruction algorithm for determining the distribution of conductivities of a body, such as bones, skin and blood vessels a basic design with components for signal acquisition (electrodes), signal processing (amplifier, A / D converter), power supply (generator, voltage-current converter, current limiting), components to control (μC). The electrical impedance tomograph provides visualization of conduction changes within a heartbeat and monitoring blood flow in the heart and vessels, as well as time dependencies on circulating cardiac output in the form of an impedance cardiogram with additional information on cardiac function. With the help of this visualization further applications for the detection of internal bleeding, external inflammation, examinations of digestive organs, tumor monitoring, mastitis and various forms of lung disease are possible. Furthermore, a monitoring of temperature changes of internal organs is possible.
US Pat. No. 5,807,251 states that in the clinical application of EIT it is known to provide a set of electrodes placed in electrical contact with the skin at a certain distance from one another, for example around the chest of a patient and applying an electrical current or voltage input signal alternately between different or all of the possible pairs of electrodes arranged adjacent to each other. While the input signal is applied to one of the pairs of electrodes disposed adjacent to each other, the currents or voltages between each adjacent pair of the remaining electrodes are measured and the obtained measurement data is processed in a known manner to provide a representation of the resistivity distribution over a cross section of the Patient to whom the electrode ring is arranged to receive and display on a screen.
From US 5,272,624 it is known to use a medical electrical impedance imaging method using fixed current patterns which are fed into the feed electrodes.
US 5 184 624 shows an arrangement of a plurality of electrodes for an electrical impedance measurement on a body, with supply of electric current via a pair of electrodes in the body and the detection of voltage potentials on the body via the remaining pairs of electrodes. In this case, in the manner of a circulation around the body, in each case two electrodes from the plurality of electrodes are selected one after the other for the feeding pair of electrodes, and a plurality of the remaining electrodes are used as electrode pairs for detecting the voltage potentials.
No. 4,486,835 describes an apparatus for electro-impedance tomography, with which the input of electrical signals to selected first electrode pairs on a body and the detection of electrical signals at selected second electrode pairs with a predetermined sequence by means of a multiplexing Device is passed and is passed to a coupled to the multiplexing device computing device for determining electrical properties of a plurality of local regions of the body. These local regions are arranged in a 3-dimensional imaging grid structure in the body and continuously updated in an iterative process, the electrical conductivity at the plurality of local regions.
US 5 311 878 describes a method and apparatus of electro-impedance tomography for real-time imaging. Electro-impedance measurement signals from two selected adjacent electrodes of electrodes arranged around a thorax are fed to digital signal processing at selected inputs while a feed current is fed into selected electrodes, and real-time images are generated by means of a computer-based reconstruction.
[0009] In addition to devices for electrical impedance tomography (EIT), other medical devices suitable for imaging, such as, for example, a wide variety of radiological devices, such as X-ray devices (X-ray), computer tomographs (CT), nuclear magnetic resonance devices (NMR), nuclear spin or magnetic resonance imaging (MRI, MRI) as well as sonographic devices for cardiac, angiological, prenatal or neonatal imaging, which enable real-time imaging and providing of signals or image data in the field of healthcare.
US 3,310,049 A describes a method for determining the heart volume by means of ultrasound.
From US 5 052 395 A an ultrasonic pulse Doppler device for sonographic determination of the performance of the heart (cardiac output) is known.
For example, US Pat. No. 4,075,482 A discloses a gamma radiation-based X-ray tomography system.
US 4,806,867 A shows a magnetic resonance imaging system.
In US 4 149 081 A a device for improved image reconstruction of computer tomograms is described.
In a radiological-cardiological examination by means of such computer tomographs (CT) according to the prior art, a contrast agent is used in a conventional manner, which is introduced via an access invasive in the patient. Such a contrast agent, in particular when a radioactive isotope is used, represents an extraordinary physical burden on the organism and thus makes continuous imaging monitoring of vital functions of the heart and lungs impossible. In order to generate evaluable images with regard to the condition of the coronary arteries of the heart, it is furthermore necessary to carry out the tomographic recordings in rest phases of the heart, or to determine the corresponding usable data by means of post-processing of the tomographic recordings. The tomographic images are combined with an electrocardiogram (ECG) using two proven methods, the so-called "prospective ECG triggering" or the so-called "ECG gating". In "prospective ECG triggering", the resting phases of the heart are determined by means of ECG and synchronized with the tomographic recordings, in which the patient is then transilluminated layer by layer by table feed. Thus, there is no real-time total recording of the heart at the same time instead, but the individual, layer-by-layer information obtained are subsequently assembled. In ECG gating, a so-called "spiral CT", in which the tube is rotated and the table feed is performed simultaneously, provides a real-time tomographic image of the entire heart and continuous acquisition of ECG signals. After the examination, the tomographic images are processed using the ECG signals by means of the "ECG gating" and thus evaluable images are generated. A disadvantage of both methods is that the computer tomograph (CT) additionally requires an ECG signal for synchronization as an external signal; furthermore, it is disadvantageous in the case of "ECG gating" in particular that the patient does not breathe during tomographic examination by means of spiral CT may and that the post-processing of the collected data is very time-consuming and the result is thus not present during the investigation itself, but only with a time delay. Magnetic Resonance Imaging (MRI) also requires synchronization with an electrocardiogram (ECG) to combine data from multiple cardiac cycles into complete images, as well as the use of contrast agents, resolution, and contrast to improve the tomographic recordings. These exemplary embodiments for imaging by means of MRI or CT in the cardiac environment are transferable to the imaging (angiology / angiography) of the lung by means of MRI, CT in the basic sense.
Furthermore, these exemplary embodiments clearly show that devices for electrical impedance Impedance Imaging (EIT) in comparison to magnetic resonance imaging (MRI) and computer tomography (CT) have significant advantages, essentially in the following aspects :EIT has real-time functionalityEIT does not require coupling to ECGEIT does not require a contrast agent
With regard to sonographic devices for cardiac, angiological, prenatal or neonatal imaging is to be noted that these are limited in the application to temporary examinations, since the transducer in conjunction with the contact gel led by the user and the orientation of the transducer, as well as the function of the contact gel must be visually observed by the user during the examination. This results in the following advantages:EIT does not need a contact gelEIT does not require continuous functional monitoring by the user
The electrical impedance tomography (EIT) is thus, in contrast to the other medical imaging devices (X-ray machines, computer tomographs, magnetic resonance tomographs, sonographic devices), which are suitable for imaging, for a continuous and permanent imaging, in particular of Lung as well as the lungs and heart, without causing any significant physical stress or discomfort for the patient.
EP 1 292 224 B2 describes a method and a device for displaying data obtained by means of electrical impedance tomography. Various special modes for evaluation are described, on the basis of which an analysis of the condition of a lung of a patient is provided. Thus, a relative mode is provided that processes regional changes in a two-dimensional distribution of ventilation for a past period of time. There is further provided a perfusion mode that processes a two-dimensional distribution of lung perfusion in a past period of a cardiac cycle. Furthermore, a phase shift mode is provided, which processes a dynamics of ventilation. Further modes described in this EP 1 292 224 B2 are absolute mode, time constant mode and a regional spirometry mode. The different modes are used to distinguish different lung conditions. To distinguish between different lung conditions, one of the modes or several of these modes will be sequentially selected for operation. All modes described in this EP 1 292 224 B2 have in common that no modes and no combination of modes are provided which allow or enable a common presentation or processing of perfusion and ventilation.
In the ventilation of a patient, especially in intensive care, it is of central importance that the patient's lungs both vented as best possible (ventilated), as well as perfused (perfused) is. For only if the best possible perfusion and the best possible ventilation (ventilation) are given over as large areas of the total available lung volume, gas exchange, i. the introduction of oxygen from the lungs into the bloodstream and the transmission of carbon dioxide from the bloodstream via the lungs out of the patient are effective.
Depending on the constitution, medication and clinical picture of the patient and depending on the settings of ventilation on a ventilator, with the help of which the patient is ventilated, arise, without direct reference to specific disease states (eg atelectasis, emphysema, pneumonia, embolism) in the lung of the patient the following different basic physical constellations A-D in different local lung areas:<tb> Constellation A: <SEP> Lung areas with adequate ventilation and with adequate perfusion,Constellation B: Lung areas with adequate ventilation and insufficient perfusion<tb> Constellation C: <SEP> Lung areas with insufficient ventilation and with adequate perfusion,<tb> Constellation D: <SEP> Lung areas with insufficient ventilation and insufficient perfusion.
This distinction in four constellations in the lungs is a simplified classification common in the prior art, as is also the case in EP 1 292 224 B2 (FIG. 1).
The EIT is able to differentiate locally from the impedance differences between air / gas to blood to differentiate between perfusion and ventilation. In one breath of a patient several heartbeat cycles are present at the same time. With every heartbeat, blood flows in and out of the lungs.
The heartbeat cycles have a certain variability in the heartbeat frequency and are asynchronous to respiration and different from the respiratory rate.
Consider now an EIT sequence of local impedance changes or impedances of different regions of the lung for one or more breaths as a kind of overlay of local cardiac and perfusion related impedance changes CPRS (Cardiac and Perfusion Related Signal) and local ventilation induced impedance changes VRS (Ventilation Related Signal), the blood flow (perfusion-related impedance changes) from the lung to the heart and from the heart to the lung of the respiration (ventilation-related impedance changes) is superimposed.
The cardiac and perfusion-induced impedance changes (CPRS) are divided into cardiac induced impedance changes CRS (Cardiac Related Signal), which are based essentially on the respective degree of filling of the heart and perfusion-related impedance changes PRS (Perfusion Related Signal), which on the blood distribution ( Pulmonary perfusion) in lung tissue.
The superposition between VRS and CPRS, or PRS has the consequence that in the image sequence is not visually recognizable, as the constellation in terms of perfusion (PRS) and ventilation (VRS) in a local lung area is respectively. On the one hand, the visual recognition is made even more difficult by the fact that impedance differences of air-filled lung areas with respect to the surrounding tissue (muscles, skin, bones) are significantly greater than the impedance differences of blood-filled lung areas with respect to the surrounding tissue (muscles, skin, bones) and Thus, the CPRS compared to the VRS has a much lower signal. In addition, the visual recognition and quantitative evaluation of the perfusion is made more difficult by the phase shift of the blood flow through the pulse transit time between heart and lung tissue. The human eye and, in conjunction with it, the cognitive attention naturally follow a movement in the image, in this case the progression of the blood flow in the image sequence, and at the same time are barely able to measure the strength and its changes of a signal at a specific location over several images of the image sequence to determine.
A location-related consideration of different lung areas at a temporal observation time in relation to the beginning of the pulse wave at the heart results in a comparison of the perfusion signals of two different regions (area A, area B) of the lung that in one region (area A) the Circulation is given with a certain quantity, while at the same time of observation in another region (area B), the perfusion thereof is quantitatively clearly different. This is explained by the fact that the pulse wave, starting from the heart, does not reach the different regions of the lung at the same time, but with the propagation of the pulse wave into the blood vessels of the lung depending on the vessel length and vessel properties (flow resistance, elasticity) delayed in time. This delay is noticeable as a phase shift between the perfusion signals.
This phase shift is perceived in the EIT image sequence in a visual evaluation as a kind of "progression of blood flow", which takes place in reality in the lung tissue but in this form neither real time nor quantitative in this form. Summing the magnitudes of multiple perfusion signals without involving the phase information at a point in time over several areas therefore does not give a quantitative overall picture of the perfusion over several areas of the lung. Due to these phase differences of the blood flow between different regions of the lung, a summation of perfusion signals of several lung regions results in a partial extinction of the perfusion signals, so that no usable quantifiable statement for the perfusion of the entire lung or regions of the lung is possible in this way. Also, summing a plurality of perfusion signals at a single location or multiple, particular locations, such as one or more breaths, portions of a breath, such as inspiration and expiration, or multiple breaths, may not be appropriate local images from which differences in perfusion between different areas of the lung are clearly and clearly visible. For example, summation over a breath results in a summation over several heartbeat cycles, so that for a given location the perfusion fluctuates several times in a single breath and blood flows to that particular location and outflows again, so perfusion for that particular location as well can not be quantified on average.
It is an object of the present invention to provide a method, a device and a system for processing and visualizing data obtained by means of a medical device, for example an electro-impedance tomography device, suitable for generating data for imaging to provide a quantifiable evaluation of perfusion of at least one region of the lung or at least one region of the lung and the heart, respectively.
An additional task related to this object results therefrom, on the basis of data provided by an electro-impedance tomography device or with the aid of an improved electro-impedance tomography system, an improvement of the location-related evaluability with respect to Perfusion of at least a portion of the lung or at least a portion of the lung and the heart to achieve.
These and other objects are achieved by the appended independent claims, in particular by a method having the features of claim 1 and by a device having the features of claim 20.
The object is further achieved by a system having the features of claim 32.
Advantageous embodiments of the invention will become apparent from the dependent claims and are explained in more detail in the following description with partial reference to the figures.
Furthermore, the method may also be provided as a computer program or computer program product such that the slot size of the present application also extends to the computer program product and the computer program.
According to a first aspect of the invention, in a method according to the invention for the processing and visualization of data obtained by means of a medical device suitable for imaging with regard to a perfusion of at least one region of the lung or at least one region of the
Lung and heart data of a medical device suitable for imaging processed in a sequence of steps, so that a quantifiable evaluation of a perfusion of at least a portion of the lung or at least a portion of the lung and the heart is possible. The sequence of steps is divided into the following steps:Providing an amount of cardiac and perfusion-related signals (CPRS) over a within one observation period waveform from at least one location within the at least one region of the lung or the at least one region of the lung and heart data obtained by the medical device.Determination and provision of phase information of cardiac and perfusion-specific signals with respect to at least one comparison variable,Processing the amount of data on signals (CPRS) with respect to the perfusion of areas of the lung or areas of the lung and the heart of a patient, taking into account the determined phase information to determine and provide a data volume of at least one location- and perfusion-specific variable characteristic of the observation period,Generating and providing an output signal for a location-specific representation of the data quantity of the at least one location- and perfusion-specific variable characteristic of the observation period, andVisualization of the output signal.
This step sequence of the processing of data is continuously repeated in the process according to the invention in a continuous process. The processed data are thereby provided as output signals, preferably suitable for image representation, continuously. For the purposes of the present invention, further steps according to further or preferred embodiments are included individually or in combination in the step sequence.
In the following some of the terms used in this patent application will be explained in more detail.
For the purposes of the present invention, the observation period is a time segment in a time course. The beginning and end of such a period of observation are given by events which are given by the properties of respiration or respiration, characteristics of cardiac activity, characteristics or peculiarities of cardiac resuscitation and usually also in the signals of the amount of heart and perfusion specific signals (CPRS). reflect. Examples of cardiac-specific periods of observation include a cardiac cycle, multiple cardiac cycles, portions of cardiac cycles, such as systole or diastole, time periods of cardiac cycles that cover specific ECG ranges or intervals (P-wave, QRS complex, T-wave, U-wave, PQ). Interval, QT interval, ST segment). Examples of breath-specific periods of observation include a respiratory cycle, multiple respiratory cycles, portions of respiratory cycles such as inspiration, inspiratory pause, exhalation, expiratory pause, as well as portions of one or more respiratory cycles, e.g. several inspirations, several exhalations. Further observation periods, especially for mechanical ventilation, may be specific pressure levels, such as plateau pressure or PEEP (Positive End Expiratory Pressure, PEEP) or time intervals, which have certain characteristics of respiratory forms (eg bi-level positive airway pressure, BiPAP).
Another possible period of time for a period of observation results from the possibility that a specific amount, a so-called bolus, a special liquid, such as a saline solution, is supplied to the amount of blood in the body in an invasive manner. This bolus flows into the heart with the bloodstream and causes a characteristic signal curve during the imaging of the lungs and / or the heart. This waveform, in conjunction with the time of invasive bolus delivery, may serve as the basis for establishing a viewing period.
The data volume of heart and perfusion specific signals (CPRS) is provided in a preferred embodiment as a data set of EIT data from electro-impedance tomography (EIT). For the purposes of the present invention, EIT data are to be understood as the following signals or data:EIT raw data, i. measuring signals detected by an EIT device by means of a group of electrodes or by means of an electrode belt, such as voltages or currents associated with electrodes or groups of electrodes or positions of electrodes or groups of electrodes on the electrode belt.EIT image data, i. Data or signals obtained from the EIT raw data using a reconstruction algorithm that reflects local impedances, impedance differences, or impedance changes of areas of the lung or areas of the patient's lung and heart.Classified EIT data, i. EIT image data or signals pre-sorted or pre-classified according to predetermined criteria. The classification may include, for example, a typed division into EIT data or signals representing cardiac and perfusion-related (CPRS) impedances, impedance differences, or impedance changes, and EIT data or signals, which are ventilation-related impedances, impedance differences, or impedance changes (Ventilation Related Signals, VRS) to be implemented.Specially classified EIT data, i. EIT image data or signals pre-sorted or pre-classified according to specific predetermined criteria. The special classification may, for example, additionally include a typified division into EIT data or signals which essentially comprise perfusion-related (PRS) impedances, impedance differences or impedance changes of the lung and into EIT data or signals which are perfusion-related (cardiac-related signals CRS) to reflect impedances, impedance differences or impedance changes of the heart.
In further preferred embodiments, it is provided for the purposes of the present invention that the data volume of cardiac and perfusion-specific signals (CPRS) is also described as:Medical Device Data Providing Computer Tomography (CT) Based ImagingMedical Device Data Providing X-Ray (X-Ray) Imaging Data;Data of a medical device providing magnetic resonance tomography (MRI) or MRI imaging;Data of a medical device providing sonography (ultrasound) based imaging.
The determination and provision of the phase information of cardiac and perfusion-specific signals with respect to the at least one comparison variable is preferably carried out using mathematical methods for signal and data processing, which on a phase analysis in the frequency domain, an analysis of time delays in the time domain or based on a cross-correlation of the signals in the time domain. Phase information in the sense of the present invention includes any type of information regarding phase lag, phase difference or phase differences, and time delays or time shifts of signals or signal portions in the waveform within the observation period with respect to perfusion of one or more regions of the lung or heart to a reference or comparison magnitude to another area of the lung or heart, for example. Furthermore, the term "time delay" in the sense of the present invention means any type of time delay or time shift of signals or signal components in the signal course within the observation period with respect to ventilation of one or more regions of the lung to a reference or comparison parameter, for example to another region of the lung , with covers. Time delays of perfusion signals or ventilation signals are in the time domain by an analysis of the waveforms within the observation period with respect to the time interval between characteristic signal structures, such as zero crossings, amplitude maxima or amplitude minima, under- or exceeding thresholds, in the waveform or at least two signals to determine each other or a signal to a comparison variable by comparing the waveforms. Furthermore, in the sense of the present invention, phase information in the spectral region of the cardiac and perfusion and / or ventilation-specific signals present phase shifts, phase differences or phase positions of different areas, locations, pixels of a region or multiple areas of the lung or heart are characterized. Likewise, within the meaning of the present invention, such phase information is included, which is determined by mathematical transformations such as FFT, Laplace transformation, Z transformation, wavelet transformation, the data sets of cardiac and perfusion and / or ventilation specific signals and by appropriate inverse transformation as Phase information can be determined.
In a preferred embodiment, a signal or a waveform is used as the comparison variable of a further location different from the at least one location from the data volume of cardiac and perfusion-specific signals (CPRS).
In a further preferred embodiment, a signal or a waveform in the observation period is used as a comparison variable, which characterizes the phase position of the heart, from the data volume of cardiac and perfusion-specific signals (CPRS). Due to the continual change from contraction (systole) of the heart and relaxation (diastole) to the rhythm of the heartbeat, of the amount of cardiac and perfusion-related signals (CPRS), the location of the heart is a location-specific subset of data Distorted in the rhythm of the heartbeat very similar resulting impedance changes and thus suitable as a basis for the derivation of the comparison size. Since the spread of blood in the ventricle occurs without significant delays, the phasing of the locations that together represent the location of the heart (heart region) are only slightly different. There are time delays of the circulation within the region of the heart of about 20 ms, resulting in a heart rate of 60-80 beats per minute to phase differences of only about 7 ° to 10 °. On the basis of these physiological-cardiac correlations, it is advantageous to determine the phase position of the heart from the data volume of heart and perfusion-specific signals (CPRS) and to use this phase position of the heart as a comparison variable for the processing of the data volume of signals (CPRS) with regard to the perfusion to use a location-specific and perfusion-specific variable characteristic for the period of observation.
In a further preferred embodiment, from the amount of cardiac and perfusion-specific signals (CPRS) a signal or waveform is used in the period of observation as the comparison quantity, which has a least degree of agreement with respect to the phase position with the plurality of signals of the amount of data at heart and perfusion specific signals (CPRS). This results in an advantageous manner for the amount of data a kind of «mathematical zero phase», to which the other location-specific signals of the data volume can be mathematically normalized or related to the further data processing. The processing of the amount of data on signals (CPRS) with respect to the perfusion of areas of the lung or areas of the lung and the heart of a patient taking into account the determined phase information is used to identify and provide a data set with at least one location- and perfusion-specific variable characteristic of the observation period. The characteristic quantity represents a measure of the perfusion at a specific location or multiple locations of the lung or heart, which is characteristic of the perfusion during the observation period.
For the purposes of the present invention, characteristic variables which are specific to location and perfusion are any quantities which, by means of a mathematical relationship, are an adaptation, equalization, evaluation, weighting of signals or data, groups of signals or data of the at least one location represent at least one comparison variable in terms of perfusion. These include, for example, manipulations of signals or signal curves of the at least one location over a period of observation, such as summations, integrations, formation of average values, median values and averages of various types, such as arithmetic mean, geometric, harmonic or quadratic averages RMS,) maximum and minimum values, relations to maximum values, to minimum values, to mean values or to certain threshold values or to specific levels or tolerance bands.
In a preferred embodiment, the at least one characteristic location- and perfusion-specific variable determined on the basis of the phase information is at least one comparison variable by balancing the phase difference of the at least one signal from the data set of cardiac and perfusion-specific signals (CPRS) the synchronized cardiac, heart and perfusion-specific signal (sCPRS), synchronized with the at least one comparison variable. The synchronization of the cardiac and perfusion-specific signals with respect to the at least one comparison variable is preferably carried out with the aid of mathematical methods for signal and data processing, which are based on a phase adjustment in the frequency spectrum or on a shift of individual data sets in the time domain. The phase adaptation in the frequency spectrum takes into account - after transformation of the time signals into the frequency range - respective frequencies or ranges of frequencies of the signals, which are to be assigned essentially to the cardiac activity, the associated site-specific phase values. The shifting of individual data sets in the time domain shifts the signals or signal curves in the observation period in relation to a comparison variable, preferably to a different location than the comparison parameter.
In a particularly preferred embodiment, a synchronization for a plurality of signals from the amount of cardiac and perfusion-specific signals (CPRS) is performed over a waveform or over a period of observation as a characteristic location- and perfusion-specific variable. The site-specific phase differences are matched to one another by synchronizing the phases of the signals to the phase position of the heart. The multiplicity of signals from the data volume of cardiac and perfusion-specific signals (CPRS) thereby reflects a substantial part of the lungs and also of the heart, so that in this way, over substantial parts of the lungs and heart, a data set of location-specific and perfusion-specific characteristic quantities Site-specific perfusion of lung and heart as a data set of synchronized cardiac and perfusion-specific signals (sCPRS) relative to the phasing of the heart.
In a further particularly preferred embodiment, in a further step, provision is made of a volume of ventilation-related signals (VRS) over a signal course in the observation period of at least one location with regard to the ventilation of areas of the lung over a period of observation , In a variant of this further particularly preferred embodiment, in the further step, a common provision of a data set containing the amount of data (CPRS) of cardiac and perfusion-specific signals (CPRS) and the amount of data of ventilation-specific signals (VRS).
In a step following this step of the joint provision, in a further particularly preferred embodiment, the data is jointly provided in a further step in a distinction between the amount of cardiac and perfusion-specific signals (CPRS) from the data volume of ventilation-specific signals (VRS).
The distinction between the heart and Perfusionsspezifischen signals (CPRS) and the ventilation specific signals (VRS) is carried out by means of mathematical methods and model functions for data separation. Examples of such signal and data analysis and separation techniques are Principal Component Analysis (PCA), Independent Component Analysis (ICA). Principal Component Analysis (PCA) is based on least squares minimization techniques and the highest data variance analysis, the independence analysis (ICA) model based on maximum statistical independence between the signals to be separated.
The distinction of the data sets (CPRS, VRS) can also be done using mathematical frequency-selective methods (DFT, FFT). Due to the difference in the heart cycle (heart rate: about 60 to 150 beats per minute) from the breathing cycle (respiratory rate: about 12 to 45 breaths per minute) there is a clear difference in the frequency ranges and thus a distinction in the frequency range between the perfusion is associated Signal components and the ventilation associated signal components sufficiently well possible.
In a further particularly preferred embodiment, a data quantity of synchronized ventilation-specific signals (sVRS) is determined and provided in a further step from the data volume (VRS) of ventilation-specific signals. In the data set of synchronized ventilation-specific signals (sVRS), taking into account the phase information determined, the phase positions of the ventilation-specific signals of individual locations in relation to one another during the observation period are synchronized or synchronized with one another. The synchronized ventilation-specific signals (sVRS) have the advantage that during the observation period, for example during the duration of the inhalation or exhalation, varying intensities of the ventilation of individual lung areas over the observation period are compensated. This is advantageous for further processing of the data, preferably for reference of the ventilation with the perfusion data. These synchronized ventilation-specific signals (sVRS) therefore form the basis for an alignment of the ventilation-specific signals with the cardiac and perfusion-specific signals in a further particular embodiment, in which a synchronized ventilation-specific data set synchronized with the perfusion is determined and provided. In this further particular embodiment, the synchronized ventilation-specific signals (sVRS) are adjusted in time to the synchronized cardiac and perfusion-specific signals (sCPRS) and provided to perfusion-matched, synchronized ventilation-specific data volume (sVRS).
In a further particularly preferred embodiment, specific interest regions (regions of interest, ROI) are determined in at least one region of the lung or of the heart in a further step on the basis of the determined phase information. From the phase information, it is possible to group or group areas or locations of the lungs or of the heart with the same or similar phase relationship to a particular area of interest (ROI). In such a collection of special areas of interest, places with the same phase or similar phase are grouped into perfusion areas of interest. As an example of a special area of interest, the heart region is called general as well as the heart chamber.
Because the blood is circulated and distributed in the heart without significant delays, the phasing of the locations, which together represent the location of the heart, are only slightly different and together form a particular cardiac-specific area of interest (CRC). ROI). Other examples of heart-specific areas of interest (CR-ROI) are pulmonary vein, pulmonary artery, aorta, pulmonary artery, small or large pulmonary circulation.Similarly, there are areas in the lung where blood flow and blood distribution are similar. Examples of lung-specific areas of interest (PR-ROI) are upper, central, or lower regions of the left or right lung, respectively, or regions of the lung, such as those found after the so-called "3-compartment" Model of the lung »or deduced from it.
In a particular embodiment of this further preferred embodiment, in a further step, the amount of data on synchronized cardiac and perfusion-specific signals (sCPRS) or the amount of data of the joint provision of cardiac and perfusion-specific signals (CPRS) and ventilation-specific signals (VRS) on Based on the phase information and / or the specific interest regions (ROI, PR-ROI, CR-ROI) into a data set of perfusion-specific signals (sPRS) of the lung and a data set of perfusion-specific signals (sCRS) of the heart and as data sets of perfusion-specific signals (sPRS) the lung and perfusion-specific signals (sCRS) of the heart.
In a further preferred embodiment, in a further step, the data volume of cardiac and perfusion-specific signals (CPRS) or synchronized cardiac and perfusion-specific signals (sCPRS) and / or the specific areas of interest (ROI) and / or the amount of data is determined synchronized perfusion-specific signals (sPRS) of the lung and / or the amount of data of synchronized perfusion-specific signals (sCRS) of the heart, a determination and provision of a size corresponding to the pumping power of the heart. The pumping power of the heart corresponding quantities are, for example, the cardiac output or cardiac output, the output power of the heart, the stroke volume of the heart. Often, the term "cardiac output" is used for this size.
In a further preferred embodiment, in a further step, a combination of one of the data sets of ventilation-specific signals (VRS, sVRS, sVRS) with one of the data sets of synchronized perfusion-specific signals (sCPRS, sPRS) to a data set of specific parameters, which characterize the condition of the lungs in terms of perfusion and ventilation as characteristic location- and perfusion-specific parameters over the observation period. For this purpose, a quotient of ventilation-specific signals and perfusion-specific signals is preferably formed. Particularly preferred is the formation of the ventilation-to-perfusion ratio (VQ ratio), the so-called V-to-Q ratio (sV / Q), of ventilation-specific signals (VRS) or synchronized ventilation-specific signals (sVRS, sVRS). to the synchronized perfusion-specific signals (sPRS), which characterizes the condition of the lung with regard to perfusion and ventilation in a site-specific manner. One of the respiration-specific observation periods is preferably selected as the temporal reference of the signals, since a qualitative and quantitative statement regarding perfusion and ventilation for individual regions of the lung and for respiration or respiration is possible based on the physiological relationships of the gas exchange in the lung. without that time delay of blood exchange, blood flow, blood inflow and outflow into the lungs can alienate the statement. The so-called V-to-Q quotient (sV / Q) indicates for individual areas of the lungs whether an area is better perfused than ventilated, better ventilated than perfused, well-ventilated, aerated or neither adequately aerated nor perfused. As stated previously for EP 1 292 224 B2, this results in a classification into these four constellations by way of example and advantageously, so that a classification of the V-to-Q ratio (sV / Q) to these four constellations in a simple manner and advantageously the Condition of the lungs reflects. If the synchronized ventilation-specific signals (sVRS, sVRS) are used to form the quotient as ventilation-specific signals, flow-related delays or delays in the gas exchange of the lung due to patient storage effects are advantageously additionally reduced, and the statement of the invention improves Quotients (sV / Q).
Such a statement is very well suited for the user to check the settings of the ventilator, such as inspiratory pressure, minute volume (MV), expiratory pressure, positive-end expiratory pressure (PEEP).
In a further preferred embodiment, in a further step from the data set of site-specific parameters (sV / Q), which characterizes the condition of the lung with respect to perfusion and ventilation site-specific, as a characteristic site-specific and Perfusionsspezifische size over the observation period, a global ventilation perfusion Characteristic value (sV / QGlobal), which allows a reduced to a numerical value statement about a middle state in terms of ventilation and circulation of the entire lung.
In a simplest embodiment, the global ventilation perfusion characteristic (sV / QGlobal) is formed as an average or weighted average, but it is also possible to use methods of differential or integral calculus, for example, for specifics of the shape of the lung, such as three-dimensionality or even peculiarities of the formation of the dataset of site-specific parameters (sV / Q) underlying basic data (EIT, CT, MRI, ultrasound).
In a particular embodiment, the method allows in a continuous flow generation of EIT data on the thorax of a patient, processing and visualization of the EIT data with respect to a perfusion of at least a portion of the lung or at least a portion of the lung and of the heart for at least one location- and perfusion-specific variable characteristic of the observation period and an indication of the characteristic variable. This method in this particular embodiment, in a sequence of steps, enables acquisition of EIT data by means of an electro-impedance tomography (EIT) device using an electrode array of a plurality of electrodes attached to or around the thorax of a patient, processing and visualization the EIT data regarding a perfusion of at least one region of the lung or in each case at least one region of the lung and of the heart within a period of observation lying signal waveform of at least one location.
The sequence of steps is divided in this method for processing and visualization of data obtained by means of an electro-impedance tomography device (EIT) with respect to perfusion of at least one region of the lung or at least one region of the lung and the heart within a period of observation of at least one location with the aid of an electrode arrangement of a plurality of electrodes attached to or around the thorax of a patient, in the following steps:Feeding an alternating current or an alternating voltage to at least two of the electrodes of the electrode arrangement and detecting measuring signals at at least two of the electrodes of the electrode arrangement, whereby in a continuous sequence in each case other two electrodes from the plurality of electrodes for the supply of the alternating current or the alternating voltage are selected; with at least two electrodes of the plurality of electrodes, the measuring signals are detected,Generation and provision of a data set of perfusion-specific signals (CPRS) by means of a reconstruction algorithm from the measurement signals,Determination and provision of phase information from the perfusion-specific signals (CPRS) with respect to at least one comparison variable,Processing the amount of data (CPRS) on signals relating to the perfusion of regions of the lung or regions of the lung and the heart of a patient, taking into account the determined phase information for determining and providing a data quantity at least one location- and perfusion-specific variable characteristic of the observation period,Generation and provision of an output signal to a display device for displaying the data quantity of the at least one characteristic of the observation period, at least one location- and perfusion-specific variable,Representation of the data volume of the at least one location- and perfusion-specific variable characteristic of the observation period on the display device, wherein the at least one location-specific and perfusion-specific variable is represented numerically, graphically or graphically over the observation period.
The embodiments described individually and in combination with one another constitute particular embodiments of the method according to the invention for processing and visualizing data obtained by means of a medical device suitable for generating data for imaging with respect to perfusion of at least one region of the lung or at least in each case an area of the lungs and of the heart. In this case, advantages and further embodiments resulting from the combination or combinations of several embodiments are nonetheless covered by the idea of the invention, even if not all possible combinations of embodiments are described in detail in each case. The above-described inventive embodiments of the method can also be embodied in the form of a computer-implemented method as a computer program product with a computer, wherein the computer is made to carry out the method according to the invention described above, if the computer program is stored on the computer or on a processor of the computer or a so-called embedded system as part of a medical device. In this case, the computer program can also be stored on a machine-readable storage medium. In an alternative embodiment, a storage medium may be provided, which is intended for storing the above-described computer-implemented method and is readable by a computer. It is within the scope of the present invention that not all steps of the method necessarily have to be performed on one and the same computer instance, but they can also be executed on different computer instances. The sequence of the method steps can also be varied if necessary. It is also possible that individual sections of the method described above in a separate, self-sellable unit (such as on a preferably located in the vicinity of the patient data analysis system) other parts on another salable unit (such as on a display - And visualization unit, which is arranged for example as part of a hospital information system preferably in a set up for monitoring several patient rooms space), so to speak as a distributed system, can be executed.
Above, the solution of the problem has been described in relation to the claimed method. Features, advantages or alternative embodiments mentioned herein are also to be applied to the other claimed subject matter and vice versa. The corresponding functional features of the method are formed by corresponding physical modules of a device, in particular by hardware components (.mu.C, DSP, MP, FPGA, ASIC, GAL), for example in the form of a processor, a plurality of processors (.mu.C, .mu.P, DSP) or in the form of instructions in a memory area which are processed by the processor.
Thus, the objects according to the invention are achieved by a device for carrying out the method for processing and visualizing data obtained by means of a medical device suitable for generating data for a perfusion of at least one region of the lung or in each case at least one region of the lung and the heart solved. This device suitable for carrying out the method is designed to carry out the processing and visualization of data in accordance with the steps described in the method, as well as to carry out the further steps described in the embodiments individually or in combination. For example, the provision of the amount of data (CPRS) to perfusion-specific signals by means of a data input unit and the generation and provision of the output signal by a data output unit. The processing of the data can be done for example by a calculation and control unit.
The data input unit preferably has interface elements, such as amplifiers, A / D converters, components for overvoltage protection (ESD protection), logic elements and other electronic components for wired or wireless reception of data and signals, as well as adaptation elements, such as code or protocol conversion elements for adapting the signals and data for further processing in the calculation and control unit. The calculation and control unit includes elements for data processing, calculation and sequencing, such as microcontroller (μC), microprocessors (μP), signal processors (DSP), logic devices (FPGA, PLD), memory devices (ROM, RAM, SD-RAM) and combinations thereof for example, in the form of an "embedded system", which are designed together and adapted to one another and configured by programming, the method for processing and visualizing data obtained by means of a medical device suitable for generating data for imaging with regard to a perfusion of at least one area the lung or at least a portion of the lung and the heart. The data output unit is designed to generate and provide the output signal. The output signal is preferably configured as a video signal (eg Video Out, Component Video, S-Video, HDMI, VGA, DVI, RGB) on a display unit connected to the output unit wireless or wired (WLAN, Bluetooth, WiFi) or on the Output unit itself, a graphical, numerical or visual representation of the period for the observation of at least one characteristic location and Perfusionsspezifischen size to allow. All of the advantages achievable with the method of the present invention are the same or similar to the described apparatus for performing the method of processing and visualizing data obtained by means of a medical device suitable for generating data for perfusion of at least a portion of the lung or to achieve at least a portion of the lung and the heart, respectively.
Further solutions to the stated objects are described in more detail below as a device according to the invention and as a system according to the invention.The advantages described for the method according to the invention can be achieved in the same or a similar manner with the device according to the invention or the system according to the invention, as well as with the described embodiments of the device or the system. Furthermore, the described embodiments and their features and advantages of the method are transferable to the device and the system, as well as the described embodiments of the device and the system are transferable to the method.
The device according to the invention has a processing and visualization of data obtained by means of an electro-impedance tomography device (EIT) with regard to a perfusion of at least one region of the lung or of the hearta data input unita calculation and control unit anda data output unit,
Wherein the device is configured to receive data by means of the data input unit, and to provide an amount of data (CPRS) of cardiac and perfusion specific signals over a time course of at least one location over a period of observation,wherein the device is designed by means of the calculation and control unit for determining and providing phase information of the cardiac and perfusion-specific signals with respect to at least one comparison signal,wherein the device by means of the calculation and control unit for processing the amount of data (CPRS) on signals with respect to the perfusion of areas of the lung or areas of the lung and the heart of a patient taking into account the determined phase information to a determination and provision of a data amount at least one for the period of observation is characteristic of location- and perfusion-specific size,wherein the device is designed by means of the data output unit to generate an output signal for a location-specific representation of the data quantity of the at least one location-specific and perfusion-specific variable characteristic of the observation period.
In another aspect of the invention, a system for processing and visualizing data obtained by means of an electro-impedance tomography (EIT) device for perfusion of at least a portion of the lung or at least a portion of the lung and the heart, respectively Solution of the tasks.
The inventive system is configured as an EIT system and has an electro-impedance tomography device, an arrangement for processing electro-impedance tomography data with a data input unit and a display device. The electro-impedance tomography device has an electrode arrangement with a multiplicity of electrodes, an operating electronics, a measured-value acquisition and evaluation unit and a data processing and calculation unit. The electrode assembly is disposed on or around the thorax of a patient. At least two of the electrodes of the electrode arrangement are designed to supply an alternating current or an alternating voltage, at least two of the electrodes of the electrode arrangement are designed to detect measuring signals. The operating electronics is designed to feed the alternating current or the alternating voltage into the electrodes. The measured value detection and evaluation unit is designed to detect the measurement signals at the electrodes. The operating electronics and the measured value acquisition and evaluation unit are configured to supply the AC or AC voltage to at least two of the electrodes and to acquire measurement signals at at least two electrodes of the electrode assembly such that in a continuous sequence, in turn, each other two electrodes from the electrode assembly be selected for feeding the alternating current or the alternating voltage and the measuring signals are detected with at least two electrodes of the electrode assembly. The data processing and calculation unit is designed to generate from the measurement signals by means of a reconstruction algorithm a data quantity (CPRS) of perfusion-specific signals over a signal progression of at least one location within a viewing period and to provide it to the data input unit. The arrangement for processing and providing electro-impedance tomography data comprises the arrangement for processing electro-impedance tomography data, a calculation and a control unit and a data output unit. The calculation and control unit is configured to determine and provide phase information of the perfusion-specific signals with respect to at least one comparison signal.
The calculation and control unit is for processing the amount of data (CPRS) on signals relating to the perfusion of regions of the lung or regions of the lung and the heart of a patient, taking into account the determined phase information for determining and providing a data volume of at least one formed the period of observation of characteristic location- and perfusion-specific size. The data output unit is configured to generate and provide an output signal for a location-specific representation of the data quantity of the at least one location-specific and perfusion-specific variable characteristic of the observation period.
The display device is designed to reproduce a numerical, graphic or pictorial representation of the at least one location-specific and perfusion-specific variable characteristic of the observation period on the basis of the output signal.
In a particular embodiment, the device or the EIT system by means of the calculation and control unit are designed for synchronization. The calculation and control unit generates a data set of synchronized cardiac and perfusion-related signals (sCPRS) as a characteristic location- and perfusion-specific quantity based on the phase information, and makes this data available to the data output unit or the display device. The generation of the synchronized cardiac and perfusion specific signal (sCPRS) is accomplished by balancing the phase differences with respect to at least one comparison quantity. The at least one comparison variable can be represented, for example, by signals from another location, different from the at least one location, from the data set (CPRS) of cardiac and perfusion-specific signals. The at least one comparison variable can furthermore be represented, for example, by a phase position of the heart from the data volume (CPRS) on cardiac and perfusion-specific signals.In a particular variant, it is also possible that the comparison variable by signals of at least one location of greatest phase difference from the amount of data (CPRS) on cardiac and perfusion-specific signals compared to the phase positions of the total amount of locations of the data amount (CPRS) at cardiac and Perfusionssspezifischen Signals is represented.
The computing and control unit performs the synchronization by means of a phase adjustment in the frequency spectrum or on the basis of a shift of individual data sets in the time domain.
In a further preferred embodiment of the device or the EIT system, the calculation and control unit compensates the phase differences to the phase position of the heart and generates synchronized heart rate and perfusion specific signals (sCPRS) synchronized to the phase position of the heart and provides them Data output unit or the display device ready.
In a further preferred embodiment, the device or the EIT system with the data input unit are configured to receive a common data set which contains cardiac and perfusion-specific signals (CPRS) and ventilation-specific signals (VRS) in common.
In a further preferred embodiment of the device or the EIT system, the calculation and control unit is designed to distinguish cardiac and perfusion-specific signals (CPRS) from ventilation-specific signals and from the common data set a data set of cardiac and perfusion-specific signals ( CPRS) and a volume of ventilation specific signals (VRS) to be generated and provided to the computing and control unit. The calculation and control unit uses mathematical methods for signal and data analysis and mathematical model functions for data separation, such as Principal Component Analysis (PCA), to distinguish between cardiac and perfusion specific signals (CPRS) and ventilation specific signals (VRS). or Independent Component Analysis (ICA).
In a further preferred embodiment of the device or the EIT system, the calculation and control unit is configured to synchronize or synchronize the ventilation-specific signals (VRS) of different regions of the lung with respect to time or in phase over a period of observation and as a Provide data set of synchronized ventilation-specific signals (sVRS) for the data output unit or the display device.
In a further preferred embodiment of the device or the EIT system, the calculation and control unit is configured, the ventilation specific signals (VRS) or synchronized the ventilation specific signals (sVRS) in time or in phase to the synchronized heart and perfusion specific To synchronize with or synchronize with signals (sCPRS) and provide as a data set of perfusion synchronized, synchronized ventilation specific signals (sVRS) to the data output unit or display device.
In a further preferred embodiment of the device or the EIT system, signals of the same or similar phase position are determined by the calculation and control unit on the basis of the determined phase information, and with regard to the circulation of the heart to specific interest regions (regions of interest; Cardiac-related region of interest (CR-ROI) and perfusion-related region of interest (PR-ROI) for at least a portion of the lungs or heart are pooled or grouped together and provided to the data output unit or display device.
In a further preferred embodiment of the device or the EIT system, the calculation and control unit is configured, the amount of data on synchronized cardiac and perfusion-specific signals (sCPRS) or the data amount of the common provision of cardiac and perfusion-specific signals (CPRS) and ventilation specific signals (VRS) based on the phase information and / or the specific interest areas (ROI, PR-ROI, CR-ROI) in a data set perfusion-specific signals (sPRS) of the lung and in a data set perfusion-specific signals (sCRS) of the heart to distinguish and the data output unit or display as data sets of perfusion-specific signals (sPRS) of the lung and perfusion-specific signals (sCRS) of the heart.
In a further preferred embodiment of the device or the EIT system, the calculation and control unit uses the cardiac and perfusion-specific signals (CPRS) or synchronized cardiac and perfusion-specific signals (sCPRS) and / or the specific areas of interest ( ROI) and / or the synchronized perfusion-specific signals (sPRS) of the lung and / or the synchronized perfusion-specific signals (sCRS) of the heart, a size corresponding to the pumping power of the heart and provided for the data output unit or the display device.
In a further preferred embodiment of the device or the EIT system, the calculation and control unit is configured to supply at least one of the data sets of ventilation-specific signals (VRS, sVRS, sVRS) with at least one of the data sets of synchronized perfusion-specific signals (sCPRS, sPRS) to a data set of site-specific parameters relating to perfusion and ventilation and to provide for the data output unit or the display device. For this purpose, a quotient, the so-called V-to-Q quotient (sV / Q), from ventilation-specific signals (VRS) or synchronized ventilation-specific signals (sVRS, sVRS) is formed to the synchronized perfusion-specific signals (sPRS) of the lung and as data volume with regard to the location-specific condition of the lung with regard to perfusion and ventilation for the data output unit or the display device.
In a particular variant of this further preferred embodiment of the device or the EIT system is from the calculation and control unit from the data set of site-specific characteristics (sV / Q), which characterizes the condition of the lung with respect to perfusion and ventilation site-specific, as a characteristic location-specific and perfusion-specific quantity over the observation period, a global ventilation perfusion characteristic (sV / QGlobal) is formed and provided to the data output unit or display device. This global ventilation perfusion score (sV / QGlobal) provides a numerically-reduced statement of a condition for ventilation and perfusion of the entire lung.
The global characteristic value sV / QGlob determined from the data set of site-specific parameters (sV / Q) can then be determined as a mean value sV / QMean, sV / QMedian as a minimum value sV / QMinor as a maximum value sV / QMax and for the data output unit or Display device can be provided.
In a further preferred embodiment, the data output unit or the display device is designed to display the data volume of site-specific parameters (sV / Q) as a numerical, graphic or pictorial representation of one of the global ventilation perfusion characteristics sV / QMean, sV / QMedian, sV / QMin, sV / QMaxnormed output.
The present invention will now be explained in more detail with the aid of the following figures and the associated description of the figures without any limitations on the general concept of the invention.
[0092] In the drawings:<Tb> FIG. 1 <SEP> a schematic representation of functional elements for processing EIT data,<Tb> FIG. 2a, 2b, 2c <SEP> schematic flow diagrams for processing EIT data,<Tb> FIG. 3a <SEP> is a schematic anatomical representation of the heart-lung region,<Tb> FIG. 3b, 3c <SEP> a presentation of EIT data showing particular areas of interest at the frontal level,<Tb> FIG. 3d <SEP> a presentation of EIT data showing particular areas of interest in the transversal plane<Tb> FIG. 4a, 4b, 4c, 4d <SEP> representation of various representation codes,<Tb> FIG. 5 <SEP> is a schematic diagram of a system for acquiring, processing and displaying EIT data.
FIG. 1 shows an arrangement 10 of functional elements for processing EIT data 3 in a schematic form. As a basic component, this arrangement 10 comprises a data input unit 50, a calculation and control unit 70 and a data output unit 90. Furthermore, a display device 99 connected to the data output unit 90 is depicted in this FIG. The display device 99 comprises means for displaying 901, such as display elements, screens, displays for displaying graphics, curves, diagrams or images or numerical value displays for the reproduction of numerical values. Furthermore, the display device 99 includes input and control elements 902, such as switches, buttons, buttons, knobs. A special embodiment variant is a touch-sensitive display (touch screen) with a combination of input and display functionalities. The data input unit 50 reads data from at least one data input 51 or a plurality of data inputs 51 from an EIT device 30 as EIT data 3. In this FIG. 1, the EIT device 30 is connected to the device 10 as an external device. However, it is within the meaning of the present invention includes that on the one hand the EIT device 30 may be formed as part of the assembly 10, on the other hand, that the assembly 10 may be formed as a part of the EIT device 30. After the reading, the data input unit 50 holds the data for further processing, either in unmodified format as EIT data 3 or in form adapted for further processing as EIT data 3. In a particular variant, the EIT data 3, 3 may already be present separately at the data inputs 51, for example as EIT perfusion data 4 and as EIT ventilation data 5. The data output unit 90 is designed to store both data at an interface 91 to one Representation as numbers 92, images 93, diagrams 94 or curves, waveforms, temporal waveforms 95, as well as data sets, in particular in the form of data compilations 96, 98 on a display device 99 (screen, monitor, data display device) to provide. For the purposes of the present invention, provision is to be understood as any form of signal or data provision for forwarding, output, display, display, printing, sending, further processing to other devices or parts of devices. In this Fig. 1, the display device 99 is connected as an external device via the interface 91 to the data output unit 90. However, in the sense of the present invention, it is included that the display device 99 can be embodied as an internal unit of the data output unit 90 or also of the arrangement 10. By means of the interface 91 are, for example, wireless or wired provision of data in a data network 300 (LAN, WLAN, Ethernet), wireless or wired provision of data for the mutual transmission of measured values and control data (eg USB, RS232, RS485, FireWire, NMEA 0183, IrDA, Bluetooth, CAN, UMTS [SMS, MMS]) in data exchange with various other external devices 200 (anesthetics or respirators, physiological monitors, cardiac output monitors, personal computers, hospital monitors) Management systems), as well as providing audio / video data (eg Video Out, Component Video, S-Video, HDMI, VGA, DVI, RGB) in various data formats (eg MPEG, JPEG etc.) for connection to the display device 99 or other display devices (screens, monitors, tablet PCs) possible. The computing and control unit 70 performs a variety of tasks within the array 10, such as coordination with the data input unit 50 and the data output unit 90. The computing and control unit 70 is preferably, for example, a central processing unit (CPU, μP) or array individual microcontroller (μC) is formed. The calculation and control unit 70 comprises further units, which are designed for the further processing, storage and processing of the EIT data 3, 3, 4, 5. Thus, a separation unit 73, a first synchronization unit 75, an optional second synchronization unit 77, a processing unit 79, and a data memory 74 are provided. In the processing unit 79 is integrated as a further component, a memory organization unit 79. The arrangement 10 further includes various elements for voltage and power supply, but which are not shown in this Fig. 1. The connections between the elements and units of the device 10 are shown in this Figure 1 only schematically, for example, the essential data connections and data inputs and data outputs are shown, however, for the sake of clarity, there are no supply lines and not all connection lines between the elements and units shown one below the other.
These units may be formed as individual elements of the computing and control unit 70, but it is contemplated within the meaning of the present invention that the computing and control unit 70 may be divided into other sub-modules and may be configured by programming thereto to provide the functions of the separation unit 73, the first synchronization unit 75, the optional second synchronization unit 77, the processing unit 79 or the storage organization unit 79 with the same effect as described for FIG. 1 in the same or modified order of processing.
The data memory 74 is designed, for example as an array of RAM memory modules, to store data sets and sets of data records and also results or intermediate results of the data processing (calculations, sorts, allocations) for the processing of the data processing and together with the storage organization unit 79 to organize.
Furthermore, a data processing unit 89 is provided, which is embodied in this FIG. 1 as a component of the data output unit 90, but in an alternative embodiment is also included in the sense of the present invention that the data processing unit 89 is part of the calculation and control unit 70 or distributed to data output unit 90 and calculation and control unit 70 may be executed.
The separation unit 73 further processes the EIT data 3, 3, 4, 5 such that the EIT data 3, 3, or the EIT perfusion data 4 and the EIT ventilation data 5 for the further processing into a first data set 501 CPRS on perfusion data sets and into a second data set 502 VRS on ventilation data sets are differentiated and organized. The separation unit 73 prepares the further processing preferably by means of a distribution and organization of the separate PRS and VRS data sets into different storage areas of the storage unit 74 by means of the storage organization unit 79.
In the subsequent further processing, perfusion phase information 601 corresponding to perfusion data sets is determined in the first synchronization unit 75 on the basis of the first data set 501 CPRS. The circulation of various areas of the lung occurs with different time delays. If one takes the contraction (systole, recognizable in the ECG with reference to the so-called R-wave) of the heart as the beginning of blood flow to the lung, the blood spreads from the pulmonary artery to different areas of the lung at different speeds. The perfusion phase information 601 maps these physiological relationships as additional information to the first data set 501 CPRS on perfusion data sets. The perfusion phase information 601 indicates the phase position in which the perfusion data sets of different regions of the lung relate to each other or to a reference time (for example, the blood inflow into the pulmonary artery or the R-wave in the ECG). On the basis of the perfusion phase information 601, all perfusion data sets of the first data set 501 CPRS are then synchronized with one another in the first synchronization unit 75 and a third data set 503 sCPRS is formed therefrom on synchronized perfusion data records.
In a subsequently optional further processing, associated ventilation phase information 602 is determined on the basis of the second data set 502 VRS on ventilation data sets in the optional second synchronization unit 77. The ventilation (ventilation) of different areas of the lung occurs with different time delays. The ventilation phase information 602 indicate in which phase position the ventilation data records of different regions of the lung are at or at a reference time. The ventilation phase information 602 is provided from the optional second synchronization unit 77 to the data output unit 90 via the data conditioning unit 89. On the basis of the ventilation phase information 602, all the ventilation data records of the second data set 502 VRS are then synchronized with one another in the optional second synchronization unit 77 and a fourth data set 504 sVRS is formed therefrom on synchronized ventilation data records.
In an alternative embodiment of the arrangement of functional elements 10, the sequence of processing from separation and synchronization in the calculation and control unit 70 can be carried out exchanged with each other, so that the separation unit 73 is connected to the first and / or second synchronization unit 75, 77 is arranged.
In an optional further subsequent processing of the ventilation data, in the processing unit 79, the fourth data set 504 sVRS on synchronized ventilation data sets is aligned with the third data set 503 sCPRS on synchronized perfusion data records and thus a fifth data set 505 sVRS on synchronized ventilation Formed records. The fifth dataset 505 sVRS is thus aligned with the third dataset 503 sCPRS. Due to the significantly different frequency ranges of heart rate (adults: 100 ± 40 beats per minute, infant: 130 ± 40 beats per minute) and ventilation frequency (adults: 12-15 breaths per minute, toddler: about 25 breaths per minute), and the Statistically random temporal variability of the heart rate and the independent random temporal variability of the respiratory rate is a permanent complete synchronization of perfusion data and ventilation data not achievable, but merely an approximation.
However, with this approximation, it can be approximately reached that the ventilation data of the fifth data set 505 sVRS on synchronized ventilation data sets and the perfusion data of the third data set 503 sCPRS on synchronized perfusion data sets from the data output unit 90 and / or Data preparation unit 89 are provided in a form that allow, for example, on the display device 99 substantially concurrent, uniform or simultaneous forms of presentation between ventilation and perfusion.
The concurrent or simultaneous presentation of perfusion and ventilation requires synchronization with phase detection of the perfusion data. The synchronization within the ventilation data 502 VRS to synchronized ventilation data 504 sVRS or their time alignment with the perfusion data to sVRS provides advantages in the further processing and display, since further calculations with the data sets can then be made with a unified time reference.
The third data set 503 sCPRS on synchronized perfusion data sets is processed in the processing unit 79 by further analysis of the perfusion phase information 601 into an eighth data set 508 sPRS on records assigned to the lung perfusion and into a ninth data set 509 sCRS in records with assignment to the cardiac perfusion / heart level. The perfusion phase information 601 is provided to the data output unit 90 by the first synchronization unit 75, the processing unit 79, and the data conditioning unit 89. In the processing unit 79 or the data processing unit 89, based on the perfusion phase information 601, further data processing of the third data set 503 sCPRS or the eighth data set 508 sPRS and the ninth data set 509 sCRS is performed on data sets to phase-specific data compilations 98. These phase-specific data compilations 98 can be used in the further processing, for example for a design of display variants (FIGS. 3b-3d, FIGS. 4a-4d). The phase-specific data compilations 98 enable synchronized forms of perfusion imaging of the lung 508 (sPRS) and / or the heart 509 (sCRS). One embodiment variant of such phase-specific data assembly 98 is a substantially synchronized representation of one or more blood-exchange cycles (blood inflow / outflow) of the lung in synchronism with one or more heart-blood replacement cycles (blood inflow / outflow).
In a first variant (sPRS & sCRS in-phase, 0 ° variant), the blood exchange in lung and heart are synchronized in phase in a common sPRS / sCRS display. Alternatively, in a second variant (sPRS & sCRS out-of-phase, 180 ° variant), the blood exchange in the lung and heart can be synchronized in phase in a sPRS / sCRS display, so that the display alternately shows the blood flow to the lungs and the blood of the heart is visible. In this case, the representation can preferably be in the form of individual images, a sequence of individual images or in the form of an essentially continuous image sequence or as a film. In this case, for example, a false-color representation is used for the graphic coding of the data, perfusion data being preferred and, for example, displayed in a red color spectrum and ventilation data being preferred and, for example, in a blue color spectrum.
In the following processing, in the processing unit 79, the second data set 502 to ventilation data sets or the fourth data set 504 sVRS or the fifth data set 505 sVRS to synchronized ventilation data records are related to the third data set 503 sCPRS or 8 Data set 508 sPRS on synchronized perfusion data sets and a sixth data set 506 sV / Q of synchronized V / Q characteristics. For this purpose, the quotient of ventilation-related signals 502, 504 and perfusion-related signals 503, 508 is preferably formed for individual lung areas, so that a specific characteristic variable results for individual lung areas, from which it can be seen which state this respective lung area has regarding ventilation (ventilation) and ventilation Has perfusion. The sixth data amount 506 sV / Q of synchronized V / Q characteristics is provided by the data output unit 90.In addition to the determination of the sixth data set 506 sV / Q of synchronized V / Q parameters, an additional global characteristic variable is optionally determined as a global sV / Q characteristic value 510 in the processing unit 79 from the sixth data set 506 of synchronized V / Q parameters. which characterizes the condition of the entire lung in terms of ventilation (ventilation) and perfusion.
This global sV / Q characteristic 510 results, for example, as a median sV / QMedian or mean sV / QMean510 of all the parameters from the sixth data set 506 sV / Q at synchronized V / Q parameters.
In addition to the global characteristic value sV / QGlobal510 as averaged value (sV / QMedian, sV / QMean) 510 over all regions of the lung, it is furthermore advantageous to set a minimum value sV / QMin510 as well as a maximum value sV / QMax510 from the optionally determine the sixth data set 506 sV / Q at synchronized V / Q characteristics, for example, to normalize the sixth data set 506 to synchronized V / Q characteristics thereon for further processing, provision, or presentation.
In the data output unit 90 and / or the data preparation unit 99, based on the sixth data set 506 sV / Q, it is preferable to distinguish, for example, four constellations A (lung areas with sufficient ventilation and sufficient perfusion), B (lung areas with sufficient ventilation and with insufficient perfusion), C (lung areas with insufficient ventilation and with sufficient perfusion), and D (lung areas with insufficient ventilation and with insufficient perfusion), and provided at the data output unit 90. This provision of these four constellations A-D at the data output unit 90 enables, for example, on the display device 99 a graphically coded output, e.g. in the form of a combined lung / heart graph 99, wherein four different colors can be assigned to these 4 constellations.
[0110] As an example, the following assignment is exemplified:<tb> Constellation A: <SEP> green<tb> Constellation B: <SEP> blue<tb> Constellation C: <SEP> red<tb> Constellation D: <SEP> gray
In addition, in FIG. 4d, for a left and right lung, it is schematically shown how such a graphically coded representation of the four constellations based on the synchronized V / Q parameters 506 in the lung / heart graph 99 is converted by way of example can be. For the assignment into one of the four constellations A-D, it is advantageous to set the parameters of the sixth data set 506 at synchronized V / Q parameters to a global sV / QGlobal characteristic (FIG. 2b), for example the median value sV / QMedian. Mean value sV / QMean510, the minimum value sV / QMin510 or to the maximum value sV / QMax510.
In a particular embodiment, ventilation and circulation are mapped together. Thus, for example, several blood exchange cycles (blood inflow / outflow) in the lungs are timed to the respiratory cycle (inhalation / exhalation) such that, in a first variant, pulmonary perfusion and lung ventilation (V & Q in-phase, 0 ° variant) in a common VQ image come to the display. In this case, a false-color representation is preferably used for the graphic coding of the data, whereby perfusion data are preferably displayed in a red color spectrum and ventilation data, preferably in a blue color spectrum. An alternative form of presentation represents as a second variant (V & Q out of phase, 180 ° variant) of a VQ imaging the average blood exchange cycle alternated with the respiratory cycle, so that in the rhythm of breathing alternately the ventilation, for example and preferably in the blue color spectrum , and the perfusion, for example, and preferably in the red color spectrum, are displayed.
As an alternative to the false color representation with colors, graphic codings based on gray tones or patterns, for example hatchings, are also included within the meaning of the present invention.
In the processing unit 79, local phase indices are determined from the third data set 503 sCPRS or from the eighth data set 508 sPRS on synchronized perfusion data records or from the first data set 501 CPRS for individual regions of the lung and in the form of a seventh data set phase index 507 in phase position -indicated perfusion records.
The data conditioning unit 89 processes the seventh data set 507 phase index in such a way that data records with the same local phase index or with a local phase index in a predetermined tolerance range of the same local phase index are combined into groups in phase-specific data compilations 98.
Based on the processing of the seventh data set 507 phase index to local phase indices, the data output unit 90 is able to provide phase-specific data compilations 98 at the interface 91. Using the phase-specific data compilations 98, regions of interest (ROI) 620 (FIG. 3 b) can be formed for the lungs and also for imaging the lung in the form of an EIT representation. Thus, as criteria for forming such special interest areas (ROIs) 620 (Figure 3b), the affiliations to groups may be applied based on the local phase index.
Preferably, the areas of the lung combined into special interest regions (ROI) 620 (FIG. 3b) are displayed on the display device with a similar graphic representation coding.
The special area of interest (ROI) grouping 620, 621 (Figures 3b, 3c) provides an image of the lungs with spatial division in combination with time-related information for perfusion. As an example, it may be mentioned that as a particular area of interest (ROI), an amount of data of the smallest blood vessels (capillaries) in the lungs could be of interest. The farther away they are from the pulmonary artery, the majority of the smallest blood vessels have an increasing time lag (phase difference) to the blood inflow at the pulmonary artery. Thus, the data volume of the smallest blood vessels via the phase-specific data compilations 98 (Figure 3b, 3c) is definable as a special area of interest (ROI) 620, 621 (Figures 3b, 3c). Further examples of specific areas of interest (ROI) are the aorta, the pulmonary artery, the small pulmonary circulation (vasa publica) and the large pulmonary circulation (vasa privata) for the supply of the lungs, with right ventricle and pulmonary artery and left ventricle and pulmonary vein or coronary vessels to call for the supply of the heart muscle.
As another example of a phase-specific data collection 98 based on the synchronized perfusion data sets (sCPRS, sCRS, sPRS), the identification, composition or provision of a quantity corresponding to the pumping power of the heart or the regional perfusion of the heart , For example, the cardiac output or cardiac output (cardiac output) are the pumping capacities of the heart. Since the blood volume of the human body flows through the pumping power of the heart alternating between the heart and the lungs, on the one hand from the eighth amount of data 508 sPRS on synchronized perfusion data records, when considering the perfusion in the lung altogether within a certain time interval (heart rate). Cycle: filling phase, diastole) is a first measure of the amount of blood that flows back from the lungs to the heart as a whole, corresponding to the pumping power of the heart.
From the ninth data set 509 sCRS on synchronized perfusion datasets, the perfusion of the heart region in a given time interval with the next contraction or systole (heartbeat cycle: R-wave T-wave) results in a second measure for the amount of blood which flows out of the heart as ejection output as a further quantity corresponding to the pumping power of the heart.
Since the amount of blood flowing from the lungs to the heart is in equilibrium with the amount expelled from the heart without loss of blood to the patient, the output of the heart can be determined both from the first measured by the eighth data set 508 sPRS on synchronized perfusion data sets Mass, as determined indirectly from the second measure determined by means of the ninth data set 509 sCRS on synchronized perfusion data sets. Both from the first and from the second measure is thus an indirect quantity which is related to the output power of the heart, also known as cardiac output (CO) or cardiac output or cardiac output, by means of the EIT on non-cardiac output. invasive way possible. The evaluation of the EIT data and the synchronization of the perfusion data thus represent an alternative to invasive procedures, such as thermodilution by means of intravenous injection and central venous catheter or even semi-invasive procedures, such as pulse contour analysis. Non-invasive methods are for the patient Physically much less stressful and associated with fewer complications and risks in terms of hygiene (germ transmission) and therefore preferable to invasive methods. The first and second measures are well-suited for non-invasive, long-term monitoring, however, since electro-impedance tomography can only detect tissue impedance, as well as gases and blood contained therein, calibration or normalization is helpful in deriving absolute values of cardiac output therefrom , In combination with an invasive administration of a defined bolus of a saline solution or with methods of thermodilution, the observation period for the data acquisition or data evaluation can be made suitable in time and thus the statement of the first as well as the second measure can be improved.
The data output unit 90 uses the interface 91 to set the first data set PRS records 501, the second data set VRS records 502, the third record sPRS records 503, the fourth record sVRS records 504, the fifth record sVRS records 505, the sixth data set of sV / Q characteristics 506, the seventh data set phase index 507, the eighth data set 508 sPRS, the ninth data set 509 sCRS, the global sV / Q characteristic 510, the data compilations 96, the phase-specific data compilations 98, as well as the perfusion phase information 601 and the ventilation phase information 602, for example to the display device 99 and also to outside the assembly 10 to the various external devices 200 or the data network 300 or available.
An optional input and control unit 80 (drawn in dashed line type in FIG. 1) is provided which is suitable for parameterization or configuration of the calculation and control unit 70 and / or the data output unit 90 or the data preparation unit 89 is trained. For connecting the optional input and control unit 80 to the calculation and control unit 70, an optional first configuration unit 78 is provided in the calculation and control unit 70. To connect the optional input and operating unit 80 to the data output unit 90, an optional second configuration unit 88 is provided in the data processing unit 89 (as part of the data output unit 90). By way of example, the parameterization or the configuration can be used to influence the manner of shaping the interest regions (ROIs) on the basis of the phase angle by defining the phase tolerance ranges for the grouping of the perfusion data and / or the indexing. As further configuration possibilities, the manner of averaging (number of breathing cycles, moving average, median filtering, frequency filtering, 50/60 Hz and noise suppression) is the design of the graphic coding of the representation on the data output unit 90, such as color settings of the ROI (gray values, false color spectrum, hatchings ), Type of synchronized representation (180 ° variant, 0 ° variant) of ventilation and perfusion, normalizations of perfusion and ventilation, eg to one of the global mean values, to minimum or maximum values, standardisations to the patient type (lung volume correlated with size, weight, gender, age, clinical pictures). Furthermore, standardizations or display variants for particular clinical pictures such as COPD, ARDS are also conceivable which can influence the function of the calculation and control unit 70 and / or the data output unit 90 by means of the optional input and operating unit 80.
2a shows an embodiment of a method for processing EIT data schematically in the form of a flow chart 100. The same elements in Fig. 2a as in Fig. 1 are denoted in Fig. 2a by the same reference numerals as in Fig. 1. In this embodiment of Fig. 2a, the EIT data is preferably as a total of EIT image data, i. using a reconstruction algorithm from the raw data determined records representing local impedances, impedance differences or impedance changes, before. The method for processing EIT data 3 will now be explained in more detail with the aid of a step sequence 101-105.In a first step 101, EIT data 3 are read. The EIT data 3 is provided, for example, as records from an EIT device 30. The EIT data 3 includes impedance values of lung, areas of the lung, and the heart of a human body obtained by means of an electro-impedance tomography apparatus. After the reading, the EIT data are available either in unaltered format as EIT data 3 or in adapted form as EIT data 3 for further processing in subsequent steps. In a second step 102, the EIT data 3 are distinguished into a first data set 501 of perfusion data records PRS and into a second data set 502 of ventilation data records VRS. The distinction is made by means of frequency-selective methods (FFT, ECG gating) based on ECG-based triggered methods or with statistical or model-based mathematical methods, such as principal component or analysis of principal components (PCA), independent-component-analysis [ICA]).
In a further preferred embodiment variant of the method for processing EIT data, in which the EIT data 3 can already be present or can be read in as data or data records separated in perfusion data PRS and ventilation data VRS, the second step 102 of the distinction simplified as a data organization in the two data sets 501 and 502 are executed. In a third step 103, perfusion phase information 601 of the first data set 501 of the perfusion data sets PRS relative to one another is determined.In an optional, expanded embodiment-represented in this FIG. 2a as a sub-functional block 103 separated by a dashed line-of the third step 103, additional ventilation phase information 602 of the second data set 502 of the ventilation data sets VRS relative to one another is determined. The determination of the phase information 601, or 602 takes place in the third step 103, or 103 based on a phase analysis in the frequency domain or based on a cross-correlation.In a fourth step 104, a third data set 503 sCPRS of synchronized perfusion data sets is determined from the determined phase information 601 and the first data set 501 of the perfusion data records PRS. In an optional, expanded embodiment-represented in this FIG. 2a as a sub-functional block 104 separated by a dashed line-of the fourth step 104, a fourth data set 504 sVRS on synchronized ventilation data sets is additionally determined from the determined phase information 602. The synchronization of the data sets of the first data set 501 CPRS and the second data set 502 VRS to synchronized data records sCPRS 503 and sVRS 504 takes place on the basis of a phase adaptation in the frequency spectrum or based on a shift of individual data records in the time domain. The synchronized perfusion data sets may be further distinguished using phase information 601 into an eighth data set of synchronized records sPRS 508 associated with pulmonary perfusion and a ninth data set of synchronized records sCRS 509 associated with cardiac perfusion. In a fifth step 105, the third data set 503 sCPRS, the eighth data set 508 sPRS or the ninth data set 509 sCRS is provided to synchronized perfusion data sets. In a further preferred, expanded embodiment-indicated in FIG. 2 a as embedded part-functional block 105 -the fifth data set 504 sVRS is additionally provided on synchronized ventilation data records in the fifth step 105. In an optional sixth sub-step 106 within the fifth step 105 - shown in dashed lines in FIGS. 2a, 2b, 2c - the third data set 503 sCPRS at synchronized perfusion data sets or / and the fourth data set 504 sVRS at synchronized ventilation data sets via a data output unit 90 in a synchronized graphical representation, each separately in individual images or in a common image, for example, on a display device 99, output. This process 100 is repeated continuously as a step sequence of steps 101, 102, 103, 104, 105, and optionally also for optional step 106, so that EIT data 3 is continuously read in and stored as synchronized data sets 503, optionally 504, 508, 509 provided and / or issued.
To this process 100 for the processing of EIT data 3, 3, optional further steps for further processing, output and display follow or are inserted in this continuous sequence 100, which now with reference to FIGS. 2b and 2c closer to be discribed. Like elements in the figures, e.g. 2c as in Figs. 1 and 2a are shown in the figures, e.g. 2c denoted by the same reference numerals as in Figs. 1 and 2a. After the provision of the fourth data set 504 sVRS and the eighth data set 508 sPRS in the optional sixth step 106, as shown in FIG. 2b, in the flow 100 in a further (seventh) step 107 from the fourth data set 504 sVRS and from eighth data quantity 508 sPRS a sixth amount of data to sV / Q characteristics 506 determined and output via the data output unit 90 on the display device 99. From the sixth data set of sV / Q parameters 506, global sV / Q characteristic values in the form of an average characteristic value sV / OMean, sV / OMedian510, are determined as minimum and as maximum characteristic values sV / QMin510, sV / QMax510 and output via the data output unit 90 on the display device 99. For the representation, it is advantageous to normalize the sixth data set 506 to sV / Q characteristics to one of these global sV / Q characteristics 510, 510, 510, in order also to detect minor regional differences in perfusion and ventilation in the lung to be able to clarify the representation vividly.
FIG. 2 c shows how the step sequence 101, 102, 103, 104, 105, 106, 107 of FIGS. 2 a and 2b in the sequence 100 show further steps for the further processing of the EIT data 3, 3, as well as for the further processing of the records 503, 504, 601, 602 connect. In a further (eighth) step 108, a local phase index is determined using the phase information 601 from the third data set 503 sCPRS or from the eighth data set 508 sPRS on synchronized perfusion data records for individual regions of the lung. The respective local phase index is compiled in the form of a seventh data set of phase index 507 on phase-position-indexed perfusion data records and provided on the display device 99 via the data output unit 90. Based on the local phase indices of the seventh dataset Phaseindex507, Perfusion Related Regions of Interest (PR-ROI) are compiled. In such a compilation, places with the same phase or similar phase are combined into perfusion areas of interest. Such perfusion interest areas can be determined in step 108 on the basis of the phase indices, for example, heart, lung, pulmonary vein pulmonary artery, aorta, pulmonary artery, small or large pulmonary circulation. Further examples and embodiments of perfusion interest regions (PR-ROI) can be found in the description of FIG. 1, as well as in FIGS. 3 a, 3 b, 3 c, 3 d, as well as in the graphical embodiment of FIGS. 4 a, 4 b, 4 c, FIG. 4d.
Shown schematically in FIGS. 3a, 3b, 3c, 3d are heart and lung as well as special areas of interest (ROI) with respect to perfusion. These areas of interest (ROI) with respect to perfusion result, for example, from phase-specific data compilations 98 (FIG. 1, FIG. 2 a). Like elements in FIGS. 3a, 3b, 3c, 3d are designated by the same reference numerals in FIGS. 3a, 3b, 3c, 3d. The same elements in FIGS. 3a, 3b, 3c, 3d as in FIGS. 1, 2a, 2b, 2c are designated in FIGS. 3a, 3b, 3c, 3d by the same reference numerals as in FIGS. 1, 2a , 2b, 2c. 3a shows in a schematic view the anatomical contours of lung and heart with left and right lung 632, 633, trachea 634 in a two-dimensional joint representation with the heart 631 and the aorta 635 and the diaphragm 636. This schematic view is shown in FIG a frontal view of the heart and lungs. A representation of elements of the skeleton, such as ribs and vertebral bodies, or other organs is omitted for reasons of clarity, although they would also be recognizable in an imaging by means of X-rays. FIG. 3a is intended to assist understanding of the following FIGS. 3b, 3c, 3d, 4a, 4b, 4c, 4d.
FIGS. 3b and 3c show, in the frontal view, images of the perfusion, corresponding to the two-dimensional representation according to FIG. 3 a, of data corresponding to medical device (EIT, CT, MRT) data suitable for the generation of data for imaging which different areas of interest (ROI) 620 are illustrated. The particular areas of interest are also shown in Figs. 3b and 3c in a frontal view, to illustrate the reference to the - shown in front of the Fig. 3a - Anatomy also graphically. It should be noted that - in contrast to chest X-ray - with the help of electro-impedance tomography, due to the position of the EIT electrodes or the computer tomography, due to the detection principle of the CT scan, no direct frontal views can be generated, but images are generated in the so-called transversal level. However, there are possibilities to subsequently generate computationally further views of the body level, such as frontal view or sagittal view, from the acquired data, for example in the case of a 3D-CT. A first specific area of interest ROI_H1651 of the circulation shows the area of the heart. A second special area of interest ROI_LLcentral652 of the blood supply shows a central area of the left lung. A third specific area of interest ROI_LRcentral653 of the blood supply shows a central area of the right lung. A fourth specific area of interest ROI_LLdownside654 of the blood supply shows a lower area of the left lung. A fifth special area of interest ROI_LRdownside655 of the blood supply shows a lower area of the right lung. A sixth specific area of interest ROI_H2 656 of the blood flow shows the area of the aorta. FIG. 3c shows further interest regions (ROI) 621 derived from the particular areas of interest according to FIG. 3b. In a seventh special area of interest ROI_LAll657 of the circulation of the lungs, the second, third, fourth and fifth areas of interest 652, 653, 654, 655 (FIG. 3b) are summarized. In an eighth special area of interest ROI_HAll658 of the perfusion of the heart, the first and sixth areas of interest 651, 656 (FIG. 3b) are summarized.In FIG. 3 d, the special areas of interest according to FIG. 3 c are shown in a schematic, scale-out manner with FIGS. 3 a, 3 b, 3 c, in a transversal view. FIG. 3d shows the seventh special area of interest ROI_LAll657 of the perfusion of the lungs and the eighth special area of interest ROI_HAIl658 of the perfusion of the heart in the transversal view.
FIGS. 4a, 4b, 4c, 4d show, in a frontal view, various representation codes for the states of perfusion of the lungs and the heart, as well as the ventilation (ventilation) of the lungs, as well as the ratio of ventilation to perfusion (FIG. V / Q), which can be used to illustrate the sPRS data, sCPRS data, as well as VRS data or sVRS, as well as V / Q characteristics. The same elements in FIGS. 4a, 4b, 4c, 4d as in FIGS. 3a, 3b, 3c are designated in FIGS. 4a, 4b, 4c, 4d by the same reference numerals as in FIGS. 3a, 3b, 3c , Illustrated in FIG. 4 a as an exemplary embodiment is a graphic scale having a structure of four exemplary gradient lines 670 for a right lung 633 of the ROI_LRcentral 653 area of interest according to FIG. 3 b, as is the case with isobars on weather maps or Contour lines in maps is common. Such a representation is advantageous if the variable to be displayed decreases or increases from the center 671 to the outside. The individual gradient lines 670 in this case show gradual gradients of the measured quantity to be displayed in relation to the center 671. Such a representation enables a coded graphic representation with essentially monochrome colors (for example red, blue, gray, white, black). The number of four gradient lines is chosen here for reasons of clarity of drawing and clarity. The number of two to ten or more gradient lines is included within the meaning of the present invention, wherein the number of gradient lines is substantially adapted to the differences in perfusion between different regions or individual locations of the lung in order to achieve a meaningful graphic coding ,FIG. 4b shows an enlargement of the monochrome representation according to FIG. 4a by means of a color intensity or transparency variation of the variable to be displayed, wherein from the central center to the outside the color intensity decreases with the gradient lines. When a substantially dark background, e.g. Black, chosen, decreases with increasing transparency, the intensity of the color from the center to the outside, a substantially light background is selected, then increases with increasing transparency, the intensity of the color from the center to the outside to. For a representation of the perfusion by means of a color in the red color spectrum in front of a dark background, a decrease of the color intensity from bright red in gradients to a dark red, scaled with a decrease in the perfusion from the center to the outside. The degree of transparency or the color intensity is graphically illustrated in this representation according to FIG. 4 b with the help of different point densities of represented zones in the area of interest ROI_LRcentral653. A high dot density corresponds to a low color intensity, a lower dot density corresponds to a high color intensity. The gradient lines 670 divide the area of interest ROI_LRcentral653 in front of a shaded background area 672 into four exemplary zones of intensity 672, 672, 672, 672 with different dot density, low dot density, correspondingly high color intensity in the center 671 , 672 of the ROl_LRcentral653 area of interest and gradually increasing dot densities corresponding to lower color intensity into the outer zones 672, 672, 672 of the ROI_LRcentral 653 area of interest.FIG. 4c shows a further embodiment of a graphical representation coding for the right lung 633 with the area of interest ROI_LRcentral653, in which four exemplary zones 673, 673, 673, 673 of the center starting from the center 671 Perfusion can be distinguished by different shades. In the red color spectrum, such a representation in the four exemplary zones results in a graphic coding with the colors dark red, bright red, orange and yellow, scaled according to the degree of the respective perfusion in the zones 673, 673, 673, 673 of the area of interest ROI_LRcentral653. The graphic coding by means of the color tones is illustrated in this illustration according to FIG. 4c by means of different symbols.The mathematical "plus" sign (+) corresponds to dark red, the mathematical "minus" sign (-) corresponds to bright red, the mathematical "number" sign (#) corresponds to orange, the "degree" sign (°) corresponds to yellow ,
In a particular variant of FIG. 4d, the intensity variation according to FIG. 4b is included in the graphic coding of FIG. 4c, so that in the area of interest ROI_LRcentral653 a stepped color gradient, starting from the center 671 to the outside, with intensity variations in the individual zones of interest ROI_LRcentral653 results. The intensity variation allows a smooth transition between the zones of different hues. This special variant can be extended as a further special variant with the inclusion of further hues, as well as brightness or color saturation to a false color representation. FIG. 4d schematically illustrates a graphical coding to illustrate the V / Q ratio for a left lung 632 and a right lung 633. A graphically coded representation of the four constellations A, B, C, D based on the synchronized V / Q. FIG. Q characteristics 506 (FIG. 1) is made in this FIG. 4d by means of an assignment of four different graphic symbols to the constellations of perfusion and ventilation 674, 675, 676, 677. Instead of the four graphic symbols, alternatively or additionally, the constellations can be assigned to hatchings or colors, such as green, blue, red, gray, as is exemplified in the following list by means of square brackets.<tb> Constellation A: diamond 674 <SEP> [green],<tb> constellation B: triangle 675 <SEP> [blue],<tb> Constellation C: circle 676 <SEP> [red],<tb> Constellation D: Cross 677 <SEP> [gray].
FIG. 5 shows an EIT system 400 comprising an electro-impedance tomography device 30, an arrangement 10 for processing electro-impedance tomography data 3 according to FIG. 1 and a display device 99 according to FIG FIG. 1. Like elements in FIG. 5 and in FIG. 1 are denoted by the same reference numerals in FIG. 5 as in FIG. 1. The electro-impedance tomography device 30 comprises an electrode arrangement 33 in the form of a belt, shown by way of example in FIG. 5, with a multiplicity of electrodes 33 which is arranged on the thorax 34 of a patient 35, operating electronics 36 which are connected by means of a supply connection 40 for feeding alternating current or alternating voltage into the electrodes 33, as well as a measured value detection and evaluation unit 37 for detecting measuring signals at the electrodes 33 by means of a measuring line connection 40. The supply connection 40 for feeding and the measuring line connection 40 are designed in this FIG. 5 as a common cable 40, but can also be designed separately. A data processing and calculation unit 38, which is designed by means of processor technology with associated data memory and suitable programming for sequential control of the AC / AC voltage feed and AC / AC current detection, calculates EIT data from the measurement signals of the electrodes 33 by means of a reconstruction algorithm 3 and transmits these to the arrangement 10. The arrangement 10 is shown very simplified in this FIG. 5, but also corresponds in the details of the arrangement 10, as shown in FIG. The arrangement 10 processes the EIT data 3, as described in FIG. 1 and in FIGS. 2 a, 2 b, 2 c, to data quantities of the perfusion sCPRS 503, sPRS 508, sCRS 509 and data volumes of the ventilation VRS 502, sVRS 504, sVRS 505, as well as to ventilation / perfusion parameters sV / Q 510, 510, 510 and provides these by means of the data output unit 90 and transmits them as numerical values 92, pictures 93, diagrams 94, curves, curves, temporal Waveforms 95, data sets, data compilations 96 or phase-specific data compilations 98 via the interface 91 to the display device 99. The display device 99 uses the means for displaying 901 the data numerically, graphically, figuratively, for example according to one of Fig. 3b 3c, 4a, 4b, 4c, 4d, preferably in the form of the lung / heart graph 99. In addition, the display device 99 comprises various means for input 902, such as switches, buttons, knobs or knobs Pots, which are provided and designed for operation, settings and configuration of the display device 99.
[0133] List of Reference Numerals<tb> 3, 3 <SEP> EIT data<Tb> 4 <September> perfusion data<Tb> 5 <September> Ventilation data<tb> 10 <SEP> Arrangement of functional elements<Tb> 30 <September> EIT device<Tb> 40 <September> Cables<tb> 40 <SEP> supply connection<tb> 40 <SEP> Test lead connection<Tb> 50 <September> data input unit<tb> 51 <SEP> Data input, data inputs<tb> 70 <SEP> Calculation and Control Unit<Tb> 73 <September> separation unit<Tb> 74 <September> Storage<tb> 75 <SEP> first synchronization unit<tb> 77 <SEP> second synchronization unit<tb> 78 <SEP> first configuration unit<Tb> 79 <September> processing unit<tb> 79 <SEP> Storage Organizational Unit<tb> 80 <SEP> Data Entry and Control Unit<tb> 88 <SEP> second configuration unit<Tb> 89 <September> data edit unit<Tb> 90 <September> data output unit<Tb> 91 <September> Interface<Tb> 92 <September> numbers<Tb> 93 <September> Pictures<Tb> 94 <September> Charts<tb> 95 <SEP> Curves, Curves, Temporal Waveforms<tb> 96 <SEP> records, data compilations<tb> 98 <SEP> phase-specific data compilations<Tb> 99 <September> display<tb> 99 <SEP> Lung / Heart Graphic<tb> 100, 100, 100 <SEP> Schedule<tb> 101 <SEP> first step<tb> 102 <SEP> second step<tb> 103 <SEP> third step<tb> 104 <SEP> fourth step<tb> 105, 105 <SEP> fifth step<tb> 106 <SEP> sixth step<tb> 107 <SEP> seventh step<tb> 108 <SEP> eighth step<tb> 200 <SEP> external devices<Tb> 300 <September> Data Network<tb> 400 <SEP> system, EIT system<tb> 501 <SEP> first dataset CPRS datasets<tb> 502 <SEP> second dataset VRS records<tb> 503 <SEP> third dataset sCPRS records<tb> 504 <SEP> fourth dataset sVRS records<tb> 505 <SEP> fifth dataset sVRS records<tb> 506 <SEP> sixth data set sV / Q characteristics<tb> 507 <SEP> seventh data set phase index of the sCPRS data sets<tb> 508 <SEP> eighth dataset sPRS records<tb> 509 <SEP> ninth dataset sCRS records<tb> 510 <SEP> global sV / Q characteristics<Tb> 601 <September> perfusion phase information<Tb> 602 <September> ventilation phase information<tb> 620, 621 <SEP> specific areas of interest (ROI)<Tb> 631 <September> Heart<tb> 632 <left> left lung<tb> 633 <SEP> right lung<Tb> 634 <September> windpipe<Tb> 635 <September> aorta<Tb> 636 <September> midriff<tb> 651 <SEP> ROI_H1, heart<tb> 652 <SEP> ROI_LLcentral, left lung, central<tb> 653 <SEP> ROI_LRcentralLunge right, central<tb> 654 <SEP> ROI_LLdownside, left lung, below<tb> 655 <SEP> ROI_LRdownside, right lung, bottom<tb> 656 <SEP> ROI_H2, Aorta<tb> 657 <SEP> ROI_H, Heart and Aorta<tb> 658 <SEP> ROI_L, lung, total<Tb> 670 <September> gradient lines<tb> 671 <SEP> Center of an area of interest<Tb> 672 <September> Background zone<tb> 672 <SEP> zones of varying intensity<tb> 673 <SEP> Zones of different colors<tb> 674-677 <SEP> different constellations of perfusion and ventilation<Tb> 901 <September> notational<Tb> 902 <September> input means

权利要求:
Claims (32)
[1]
Method for processing and visualizing data (3) obtained by means of a medical device (30) suitable for generating data for imaging with regard to a perfusion of at least one region of the lung or in each case at least one region of the lung and the heart, with the steps:Providing a data set (501) of cardiac and perfusion-specific signals over a waveform within a period of observation of at least one location within the at least one region of the lung or the at least one region of the lung and the heart from those of the medical device (30). obtained data (3),Determination and provision of phase information (601) from the cardiac and perfusion-specific signals (501) with respect to at least one comparison variable,Processing the amount of data (501) on signals relating to the perfusion of regions of the lung or regions of the lung and the heart of a patient taking into account the determined phase information (601) from the cardiac and perfusion-specific signals for determining and providing a data set (503, 506, 507, 508, 509, 510) of at least one location-specific and perfusion-specific variable characteristic of the observation period,Generating and providing an output signal for a site-specific representation of the data set (503, 506, 507, 508, 509, 510) of the at least one location- and perfusion-specific variable characteristic of the observation period, and- Visualization of the output signal.
[2]
2. Method according to claim 1, wherein the data (3) obtained by means of a medical device (30) suitable for imagingare represented as data of an electro-impedance tomography device (3).
[3]
3. The method of claim 1, wherein the data obtained by means of a medical device for imaging (30) data (3), asData of a medical device providing computer tomography-based imaging,Data of a medical device providing X-ray based imaging,Data of a medical device providing imaging based on magnetic resonance imaging or magnetic resonance tomography,- Data of a medical device, which provides on a sonography-based imaging, are represented.
[4]
4. The method according to claim 1, wherein the comparison variable is represented by signals of a further location different from the at least one location from the data set (501) of cardiac and perfusion-specific signals.
[5]
5. The method according to claim 1, wherein the comparison quantity is represented by a phase position of the heart from the data set (501) on cardiac and perfusion-specific signals.
[6]
6. The method of claim 1, wherein the comparison variable represented by signals of at least one location largest phase difference from the data set (501) of cardiac and Perfusionssspezifischen signals compared to the phase angles of the total amount of locations of the data set (501) on cardiac and Perfusionsspezifischen signals becomes.
[7]
7. The method of claim 1, wherein in a further step from the data set (501) of cardiac and perfusion-specific signals, a data set (503) is determined and provided as the at least one characteristic perfusion-specific variable in which, taking into account the determined phase information (601 ) from the cardiac and perfusion-specific signals, the phase angles of the signals of individual places to each other in the period of observation are temporally aligned or synchronized with each other.
[8]
8. The method of claim 1, wherein in a further step, providing a data set (502) of ventilation-specific signals over a time course of at least one location with respect to the ventilation of areas of the lung over a period of observation.
[9]
9. The method of claim 8, wherein in the further step, a joint provision of data with the amount of data (501) on cardiac and perfusion-specific signals and the amount of data (502) takes place on ventilation-specific signals.
[10]
10. The method of claim 9, wherein in a further step from the joint provision of data, the amount of data (501) on cardiac and Perfusionssspezifischen signals from the amount of data (502) is distinguished from ventilation-specific signals.
[11]
11. The method of claim 10, wherein in a further step phase information (602) of the ventilation-specific signals (502) are determined with respect to at least one comparison variableand in a subsequent step from the data set (502) of ventilation-specific signals, taking into account the determined phase information (602) of the ventilation-specific signals, a data set (504, 505, 506, 510) of at least one location- and ventilation-specific (504, 504, 505, 506, 510) size is determined and provided.
[12]
12. The method of claim 11, wherein in a further step from the data set (502) of ventilation-specific signals, a synchronized data set (504) is determined and provided, in which, taking into account the determined phase information (602) of the ventilation-specific signals, the phase angles of the signals Places to each other in the period of observation are aligned with each other in time or synchronized with each other.
[13]
13. The method of claim 7, wherein in a further step, the data amount of synchronized ventilation specific signals (504) to the data set of synchronized cardiac and perfusion specific signals (503) in the period of observation to a perfused synchronized, ventilation specific data set (505) is timed and provided.
[14]
14. The method of claim 1 or claim 11, wherein in a further step on the basis of the determined phase information (601) from the cardiac and perfusion-specific signals and / or phase information (602) of the ventilation-specific signals special interest areas (620, 621) in at least an area of the lung.
[15]
15. The method of claim 14, wherein in a further step from the data set (501) of cardiac and perfusion-specific signals or from the joint provision of data using the determined phase information (601) from the cardiac and Perfusionssspezifischen signals and / or phase information (602) distinguishing the ventilation specific signals and / or the particular special interest areas (620, 621) into a data set of perfusion specific signals (508) of the lung and a data set of perfusion specific signals (509) of the heart and providing those sets (508, 509) become.
[16]
16. The method of claim 15, wherein in a further step from the data set cardiac and perfusion specific signals (501) or synchronized cardiac and perfusion specific signals (503) and / or the particular special interest areas (620, 621) and / or the amount of data synchronized perfusion-specific signals (508) of the lung and / or the amount of data of synchronized perfusion-specific signals (509) of the heart, a magnitude corresponding to the pumping power of the heart is determined and provided.
[17]
17. The method of claim 7 or claim 13, wherein in a further step over the observation period the amount of synchronized ventilation specific signals (504) or the amount of perfusion synchronized, synchronized ventilation specific signals (505) are synchronized with the amount of data to synchronize heart and perfusion specific signals (503) or in proportion to the amount of data on synchronized heart and perfusion specific signals (508) of the lung, and this ratio as a synchronized perfusion and ventilation specific data set sV / Q (508) over the observation period at least one characteristic location and perfusion specific quantity (506) is provided.
[18]
18. The method of claim 17, wherein in a further step from the synchronized perfusion and ventilation specific data amount sV / Q (506) a global sV / Q characteristic value (510) is determined over the observation period and the at least one characteristic location- and perfusion-specific Size (510) is provided.
[19]
19. The method according to any one of the preceding claims, wherein as the observation period, a cardiac cycle, a plurality of cardiac cycles, a breathing cycle, multiple breathing cycles, parts of cardiac cycles or parts of breathing cycles, parts of several cardiac cycles or parts of several breathing cycles are selected.
[20]
20. A device (10) for processing and visualizing data (3) obtained by means of a medical device (30) suitable for generating data for imaging with regard to a perfusion of at least one region of the lung or respectively at least one region of the lung and the heart, WhichBy means of a data input unit (50),By means of a calculation and control unit (70)By means of a data output unit (90)- and by means of a display device (99)for carrying out the method according to one of claims 1 to 19 for processing and visualizing data (3) obtained by means of a medical device (30) suitable for generating data for imaging with regard to a perfusion of at least one region of the lung or at least one region of the lung Lungs and the heart is formed.
[21]
21. The apparatus of claim 20, wherein the calculation and control unit is configured to generate a data set of synchronized cardiac and perfusion-specific signals on the basis of the phase information as a characteristic location- and perfusion-specific variable and the data output unit. 90) or the display device (99).
[22]
22. Device according to one of claims 20 or 21, wherein the calculation and control unit (70) is configured based on the phase information (601) by balancing the phase differences to generate a synchronized to the phase position of the heart data set of synchronized cardiac and perfusion-specific signals and the data output unit (90) or the display device (99).
[23]
23. Device according to one of claims 20 to 22, wherein the data input unit (50) is configured to receive a common data set of perfusion-specific signals and ventilation-specific signals and wherein the calculation and control unit (70) is configured, the cardiac and Perfusionssspezifischen signals to differentiate from the ventilation-specific signals and to provide as a data set of cardiac and perfusion-specific signals (503) and as a data set ventilation-specific signals (502) of the calculation and control unit (70).
[24]
24. Device according to one of claims 20 to 23 wherein the calculation and control unit (70) is configured to equalize or synchronize the ventilation specific signals (502) of different regions of the lung in time or in phase relation to each other over a period of observation and as a data amount synchronized ventilation specific signals (504) for the data output unit (90) or the display device (99).
[25]
25. Device according to one of claims 20 to 24, wherein the calculation and control unit (70) is configured, the ventilation-specific signals (502) or synchronized ventilation specific signals (504) in time or in phase to the synchronized cardiac and perfusion-specific signals (503), and to synchronize as an amount of perfusion-synchronized, synchronized ventilation-specific signals (503) to the data output unit (90) or the display device (99).
[26]
26. Device according to one of claims 20 to 25, wherein the calculation and control unit (70) is designed based on the determined phase information (601) to detect signals of the same phase and to specific interest areas (620, 621) with regard to the perfusion of the heart (651, 656, 657) and for lung perfusion (652, 653, 654, 655, 658) for at least a portion of the lung or the heart, and for the data output unit (90) or display (99) provide.
[27]
The apparatus of any of claims 20 to 26, wherein the computing and control unit (70) is configured to store the amount of data of synchronized heart and perfusion specific signals (501) or the combined amount of heart rate and perfusion specific signals and ventilation specific signals on the basis of the phase information and / or the specific areas of interest into a data set perfusion-specific signals (508) of the lung and in a data set Perfusionsspezifischer signals (509) of the heart to distinguish and provide for the data output unit (90) or the display device (99).
[28]
The apparatus of any of claims 20 to 27, wherein the computing and control unit (70) is configured from the heart and perfusion specific signals (501) or synchronized heart and perfusion specific signals (503) and / or the particular particular areas of interest (620, 621) and / or the synchronized perfusion-specific signals (508) of the lung and / or the synchronized perfusion-specific signals of the heart to determine a size corresponding to the pumping power of the heart and for the data output unit (90) or the display device (99) provide.
[29]
29. The device according to claim 20, wherein the calculation and control unit is configured to generate at least one of the data sets of ventilation-specific signals (502, 504, 505) with at least one of the data sets of synchronized perfusion-specific signals (503, 508 ) to a data set of location-specific parameters (506) for perfusion and ventilation and to provide for the data output unit (90) or the display device (99).
[30]
The apparatus of claim 29, wherein the calculation and control unit (70) is configured to obtain a global ventilation perfusion characteristic sV / QGIobalal of the data set of site-specific parameters (506) for perfusion and ventilation as a mean value (510), as a minimum value (510) or as a maximum value (510) and to provide for the data output unit (90) or the display device (99).
[31]
31. The apparatus of claim 30, wherein the data output unit (90) or the display device (99) are formed, the data set of site-specific characteristics (506) as a numerical, graphical or visual representation of one of the global ventilation perfusion characteristics (510, 510 , 510) output normalized.
[32]
32. System for acquisition, processing and visualization of data (3) obtained by means of an electro-impedance tomography device (30) with respect to a perfusion of at least one region of the lung or in each case at least one region of the lung and the heart,- with an electro-impedance tomography device (30) and- with a device (10) according to any one of claims 20 to 31,wherein the electro-impedance tomography device (30) has an electrode arrangement (33), which can be arranged on a thorax (34) of a patient (35), having a plurality of electrodes (33), an operating electronics (36), a measured value acquisition and evaluation unit (37) and a data processing and calculation unit (38), wherein at least two of the electrodes (33) of the electrode arrangement (33) are designed to supply an alternating current or an alternating voltage,wherein at least two of the electrodes (33) of the electrode arrangement (33) are designed to detect measuring signals, wherein the operating electronics (36) are designed to feed the alternating current or the alternating voltage into the electrodes (33), wherein the measured value detection means and evaluation unit (37) is designed to detect the measurement signals at the electrodes (33), wherein the operating electronics (36) and the measured value acquisition and evaluation unit (37) are configured to supply the AC or AC voltage to at least two of the electrodes (33) and the detection of measurement signals on at least two electrodes (33) of the electrode assembly (33) such that in a continuous sequence successively other two electrodes (33) from the electrode assembly (33) for feeding the alternating current or the AC voltage can be selected and with at least two electrodes (33) of the electr odenanordnung (33) the measurement signals can be detected,wherein the data processing and calculation unit (38) is configured to generate from the measurement signals by means of a reconstruction algorithm a data set (501) of cardiac and perfusion-specific signals over a signal course of at least one location within a period of observation and to the data input unit (50) Provide processing of electro-impedance tomography data,wherein the apparatus (10) for processing electro-impedance tomography data comprises a data input unit (50), a computing and control unit (70), and a data output unit (90), the computing and control unit (70) for determining and providing phase information (601) of the cardiac and perfusion-specific signals (501) in relation to at least one comparison variable,wherein the computing and control unit (70) processes the data set (501) of signals for perfusion of regions of the lung or regions of the lung and the heart of a patient, taking into account the determined phase information (601) to detect and provide a data set (503, 506, 507, 508, 509, 510) of at least one location- and perfusion-specific variable characteristic of the observation period, the data output unit (90) generating and providing an output signal for a location-specific representation of the data set (503, 506 , 507, 508, 509, 510) of the at least one location-specific and perfusion-specific variable characteristic of the observation period,wherein the display device 99 is configured to reproduce a numerical, graphic or pictorial representation of the at least one location-specific and perfusion-specific variable characteristic of the observation period on the basis of the output signal.

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DE102018008545A1|2018-11-01|2020-05-07|Drägerwerk AG & Co. KGaA|Device and method for electro-impedance tomographywith determination of a heart region|

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CN110236515A|2019-07-19|2019-09-17|合肥工业大学|A kind of contactless heart rate detection method based on near-infrared video|

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申请号 | 申请日 | 专利标题

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DE102014009439.1A|DE102014009439B4|2014-06-25|2014-06-25|Apparatus and method for processing tomographic data|

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