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    • 专利摘要:
    The invention relates to a device for electro-impedance tomography devices (EIT) (30) with an electrode arrangement (33), with a measured value acquisition and feed unit (40), with a calculation / control unit (70) and with a data input unit ( 50). The calculation / control unit (70) coordinates the operation and data acquisition of EIT data (3) and is designed to determine a position of a heart region.
    公开号:CH715555A2
    申请号:CH01154/19
    申请日:2019-09-13
    公开日:2020-05-15
    发明作者:Stender Birgit
    申请人:Draegerwerk Ag & Co Kgaa；
    IPC主号:
    专利说明:

    The present invention relates to an apparatus and a method for electro-impedance tomography (EIT) with determination of a heart region.
    Devices for electro-impedance tomography (EIT) are known from the prior art. These devices are designed and provided by means of an arrangement of electrodes to generate an image, several images or a continuous image sequence by means of an image reconstruction algorithm from signals obtained with the aid of electrical impedance measurements and data and data streams obtained therefrom.
    These images or image sequences show differences in the conductivity of different body tissues, bones, skin, body fluids and organs, for example blood in the lungs and heart, and breathing air in the lungs. In addition to the heart and lungs, the skeletal structure (costal arches, sternum, spine) surrounding the heart and lungs can also be represented in a horizontal plane, the so-called transverse plane, in a horizontal sectional view.
    No. 6,236,886 describes an electrical impedance tomograph with an arrangement of a plurality of electrodes, current feed to at least two electrodes and a method with an algorithm for image reconstruction in order to determine the distribution of conductivities of a body, such as bones, skin and blood vessels, in a basic manner Design with components for signal acquisition (electrodes), signal processing (amplifier, A / D converter), power supply (generator, voltage-current converter, current limitation) and components for control (µC).
    [0005] WO 2015/048917 A1 shows a system for electrical impedance tomography. The EIT system is suitable for detecting electrical properties of a patient's lungs as impedances. For this purpose, impedance values or changes in impedance of the lungs are detected - usually continuously - by means of voltage or current feed between two or more electrodes and a signal detection on an electrode arrangement and processed further by means of data processing. The data processing comprises a reconstruction algorithm with a data processor in order to determine and reconstruct the electrical properties from the impedances. When the electrical properties are reconstructed from the acquired measurement data, an anatomical model is selected from a large number of anatomical models on the basis of the patient's biometric data and the reconstruction of the EIT image data is adapted on the basis of the anatomical model or the biometric data.
    Is stated that it is known in the clinical application of the EIT to provide a set of electrodes which are arranged at a certain distance from each other, for example around the chest of a patient in electrical contact with the skin and a to apply electrical current or voltage input signal alternately between different or all of the possible pairs of electrodes arranged adjacent to one another. While the input signal is applied to one of the pairs of electrodes arranged adjacent to one another, the currents or voltages between each adjacent pair of electrodes are measured and the measurement data obtained are processed by means of an image reconstruction algorithm in order to represent the distribution of the specific electrical resistance over a cross section of the Obtain patients around whom the electrode ring is arranged and display them on a screen.
    By means of an electrode arrangement around the chest of a patient with an EIT device, as is known, for example, from US Pat. No. 5,807,251, an impedance measurement is carried out on the chest and an image of the patient's lungs from the impedances by means of a conversion to the geometry of the Chest created. With a total of, for example, 16 electrodes attached to the chest of a patient, an EIT device can image the lungs of 32 times in one circulation of current feeds on two electrodes and record voltage measurements (EIT measurement signals) on the other electrodes Generate 32 pixels. A total of 208 impedance measurements are recorded on the 16 electrodes. From these 208 impedance measurements, the EIT image reconstruction then results in a total of 1024 pixels.
    In the context of breathing and ventilation, the spatial position and spatial expansion of the heart in the chest, thorax (chest) changes, because due to the filling and emptying of the lungs with / of breathing gas, the spatial position of the heart is influenced. On the one hand, this occurs as an essentially cyclical vertical change in the heart position through the movements of tension and relaxation of the diaphragm during so-called abdominal breathing (abdominal breathing type). However, there is also an axial change in the position of the heart by widening or narrowing the chest area or thorax by means of the intercostal muscles in so-called breast breathing (costal breathing type). In addition, with breast and abdominal breathing, in particular in the area of the costal arches, due to the filling and emptying of the lungs, there are cyclical changes in the circumference of the chest with breathing and / or ventilation. This results in the situation that, due to breathing and / or ventilation and the type of breathing (abdominal breathing, breast breathing), the spatial and local composition of the tissue types located within a detection range of the electrode arrangement both in position (vertical, axial), expansion (thoracic circumference, Chest size) and type (lungs, heart).
    Depending on the positioning of the electrode arrangement on the circumference of the chest, lung tissue as well as lung tissue and heart tissue are located in the area of the horizontal plane of the electrode plane, which is noticeable in the impedance values recorded by means of electro-impedance tomography (EIT).
    When the electrode arrangement is positioned on the circumference of the chest in the area of the fourth to sixth intercostal space, the detected impedance values, which are representative of areas of the heart and lungs in the chest area, are present. In contrast to this, when the electrode arrangement is positioned on the circumference of the chest in the area below the sixth to seventh intercostal space, the detected impedance values are representative of the areas of the heart and lungs in the chest area in a different way or to a lesser extent.
    The present invention has for its object to provide an electro-impedance tomography device and a method for electro-impedance tomography to determine a spatial position of a heart region in relation to areas of the lungs in the chest of a patient.
    Another object - closely related to the previous object - of the present invention is to provide a device and a method with consideration of the heart region when evaluating and displaying electro-impedance tomography images of a patient's thorax.
    [0013] Another object of the present invention, which is closely related to the previous objects, is to specify a device and a method for determining and providing a position of an electrode arrangement arranged on the thorax of a patient and suitable for electro-impedance tomography .
    These and other objects are solved by the attached independent claims, in particular by a device for electro-impedance tomography (EIT) with the features of claim 1.
    The object is further achieved by a method for operating a device for electroimpedance tomography (EIT) with the features of claim 13.
    The object is further achieved by a method for determining a spatial position of a heart region in relation to areas of the lungs in the thorax with the features of claim 14.
    Features and details that are described in connection with the method according to the invention apply, of course, also in connection with and with regard to the device suitable for carrying out the method and vice versa, so that with respect to the disclosure of the individual aspects of the invention is always mutually referenced, or can be.
    Advantageous embodiments of the invention emerge from the subclaims and are explained in more detail in the following description with partial reference to the figures.
    [0019] Furthermore, the method can also be provided as a computer program or a computer program product, so that the scope of protection of the present application also extends to the computer program product and the computer program.
    According to the invention, data obtained by means of an electro-impedance tomography device (EIT data) are processed in such a way that an evaluation with regard to a position of an electrode arrangement on the thorax of a patient is made possible. The electrode arrangement has a multiplicity of electrodes which are arranged spaced apart from one another around the circumference of the body in the area of the thorax of a living being. The electrode arrangement is arranged horizontally on or around a patient's thorax. At least two of the electrodes of the electrode arrangement are designed to feed in an alternating current or an alternating voltage, at least two of the other electrodes of the electrode arrangement are designed to detect measurement signals. Electroimpedance tomography (EIT) is able to differentiate locally from the impedance differences between air / gas and blood between lung tissue and tissue from the heart and blood vessels.
    [0021] A spatial position of a heart region in relation to areas of the lungs in the chest of a patient is determined. The spatial position of the heart region is variable in time and location in the rhythm of breathing and / or ventilation. Depending on the current situation of the patient's own breathing (spontaneous inspiration phases and exhalation phases) or mechanical ventilation with mechanical, purely mandatory ventilation modes (machine-mandatory inspiration phases and expiration phases) or with supporting ventilation modes with partial breathing activity of the patient (spontaneous or patient-induced inspiration phase, spontaneous or patient-induced expiration phase) there is a shift of the heart due to the alternation of inhalation and exhalation. In addition, the spatial expansion of the heart region is variable due to systole (contraction) and diastole (relaxation) in the rhythm of the heartbeat (heart rate). Another effect on the image region of the heart visible in the EIT results from the position of the patient (supine, prone, lateral) and from changes in position, e.g. B. from supine to lateral and vice versa. The height of the electrode arrangement placed on the chest, which is designed, for example, in the form of an electrode belt or electrode belt, has an effect on this. H. the vertical position of the electrodes depends on the extent to which the heart region is visible in the EIT. The spatial position of the heart region in the area of the thorax can be determined by checking by means of an analysis carried out with data processing whether and where in the measurement area of the electrode arrangement on the chest in addition to areas with impedance values, changes in impedance and / or impedance-time profiles, which are typical for lung tissue, there are also areas with impedances and impedance-time profiles, which are not typical for lung tissue but are typical for the tissue type of the heart and blood vessels. The metrological detection range of the electrode arrangement when using electroimpedance tomography (EIT) on the thorax typically results as a horizontal plane at the height of the plurality of electrodes attached around the patient's chest, the impedance values recorded by means of the electrode arrangement also partially including Tissue properties of regions of approximately 0.02 m to 0.1 m above and below parallel to the electrode arrangement around the patient's chest are also included. The electrode arrangement enables a so-called transverse view of the patient's thorax, that is, a horizontal sectional view in the plane of the electrodes arranged on the thorax. This horizontal sectional view that can be represented by EIT is a projection of the changes in conductivity in the entire area of the heart and lungs in the thorax, whereby those changes in conductivity that are further away from the EIT electrode level are weighted less in the projection with increasing distance from the EIT electrode level those conductivity changes that are in or near the EIT electrode level. In an expanded configuration of the electrode arrangement, for example, instead of an electrode belt with which a plurality of electrodes can be applied or arranged in only one horizontal plane around the patient's thorax, an electrode arrangement with, at least two, at a vertical distance from one another electrodes arranged in horizontal planes are used. To simplify matters, such an embodiment is referred to in the further course of this application as “electrodes in two electrode levels”. With the aid of such at least two - or more - a plurality of electrodes arranged in horizontal planes, three-dimensional EIT imaging (3D-EIT) can be made possible, for example. Such an arrangement of electrodes in at least two electrode planes can be used to determine the spatial position of the heart region in the area of the thorax. If the vertical distance between the two electrode planes is known, this distance information can also be included in the determination of the spatial position of the heart region in the area of the thorax. Such an arrangement can be designed, for example, as an embodiment of two separate electrode belts, as well as a type of special piece of clothing worn on the chest, as it were, as an electrode vest with two integrated electrode belts or two rows arranged at a horizontal distance, each with a plurality of electrodes . This results in a known distance between the two horizontal electrode planes, in particular in the configuration of the aforementioned special thorax garment, so that this distance information is advantageously used both in determining the spatial position of the heart region in the region of the thorax and in determining the Position of the electrode arrangement arranged on the thorax can be included. When determining the position, this distance information of the two electrode planes to one another is advantageous in particular for determining a horizontal position of these two electrode planes in relation to the position of the heart as well as in relation to the position of the lungs. In the case of a double electrode belt, in which the two electrode planes are arranged at a defined vertical distance from one another, a vertical-axial rotation of the double electrode belt on the thorax can result in significant elements in the EIT, for example the outer contour of the lungs or striking sections of the outer contour of the lungs , in the EIT image data of the two electrode planes are clearly shifted from one another. If the double electrode belt is attached too low to the thorax / torso, the result may be that the heart position cannot be identified in the EIT image data in one of the two electrode levels in the EIT. This can be evaluated as the basis for an output signal, which then indicates the vertical incorrect positioning of the double electrode belt on the thorax. The output signals can be used for instructions and / or corresponding instructions to the user. Taking into account the known, defined distance between the two electrode planes, the note can be expanded to determine the distance by which the double electrode belt has been attached to the thorax / torso too low on the thorax. The heartbeat cycles have a certain variability in the heartbeat frequency and are asynchronous to breathing and are different from the breathing frequency. There are multiple heartbeat cycles in a patient's breath at the same time. With every heartbeat, blood flows into and out of the lungs, which is reflected in different local areas and sub-areas, the so-called ROI (Region of Interest) in the impedance values, impedance changes and impedance time profiles in different ways and also in EIT visualizations and EIT images of a patient's chest can be visualized over time of breathing and / or heartbeat cycles. To differentiate between different areas (lungs, heart) in the patient's thorax, EIT measurement signals or raw EIT data, which were recorded and obtained as EIT data by means of an electro-impedance tomography device (EIT device), can be provided and made available by the latter are used for further data processing. Furthermore, EIT image data which have been recorded and obtained as EIT data by means of an electro-impedance tomography device (EIT device) and are provided by it can also be used for further data processing.
    In the context of the present invention, EIT measurement signals or raw EIT data are to be understood as meaning the following signals or data which can be recorded using an EIT device by means of a group of electrodes or by means of an electrode belt. These include EIT measurement signals or EIT data in different signal forms, such as electrical voltages or voltage measurement signals, electrical currents or current measurement signals, assigned to electrodes or groups of electrodes or to positions of electrodes or groups of electrodes on the electrode belt, such as also electrical resistance or impedance values derived from voltages and currents. For the purposes of the present invention, EIT image data are understood to mean those data which were determined using a reconstruction algorithm from the EIT measurement signals or EIT raw data and local impedances, impedance differences or impedance changes of areas of the lungs or areas of the lungs and heart of a patient. The EIT data can be limited to a specific observation period or can have been obtained as a subset of a data set acquired over a longer period of impedance values or values or data derived from impedance values. The observation period can arise in connection with breathing and / or ventilation, for example as periods with coherent inspiration phases and expiration phases or also periods with several inspiration phases or several expiration phases.
    The data processing of the EIT data is structured in the following manner, and is carried out in the method according to the invention for operating a device for electroimpedance tomography (EIT), or in the device according to the invention for electroimpedance tomography (EIT) by means of a coordinated interaction of a data input unit , a data output unit and a calculation and control unit in order to automatically determine a current spatial position of a heart region in relation to areas of the lungs in the thorax:Provision of a data set of EIT data,Determination of a first amount of data with data indicating the spatial and local distributions of impedance values and / or changes in impedance of areas of the lungs in the thorax on the basis of the amount of data of EIT data,Determination and provision of a first output signal which indicates a current spatial position of areas of the lungs in the thorax on the basis of the amount of data on EIT data and on the basis of the first amount of data,Determination of a second amount of data with data indicating the spatial and local distributions of impedance values and / or impedance changes of areas of the heart in the thorax on the basis of the amount of data of EIT data,Determination and provision of a second output signal which indicates a current spatial position of a heart region in relation to areas of the lungs in the thorax on the basis of the amount of data of EIT data and on the basis of the second amount of data,
    In the method according to the invention for operating a device for electroimpedance tomography (EIT), after a data set of EIT data has been made available, a first data set of spatial and local distributions of impedance values and / or impedance changes is determined on the basis of the data set of EIT data areas of the lungs in the chest and a determination of a second data set of spatial and local distributions of impedance values and / or changes in impedance of areas of the heart in the chest. In the method according to the invention for determining a spatial position of a heart region in relation to areas of the lungs in the thorax, the above-described structure of the data processing is preferably implemented as a sequence of steps:
    Step 1:
    [0025]Provision of a data set of EIT data,
    Step 2:
    [0026]Determination of a first amount of data based on the amount of EIT data. The first set of data indicates spatial and local distributions of impedance values and / or changes in impedance of areas of the lungs in the thorax.Determination and provision of a first output signal based on the amount of data on EIT data and on the basis of the first amount of data. The first output signal indicates a current spatial position of areas of the lungs in the thorax.
    Step 3:
    [0027]Determination of a second data volume with data based on the data volume of EIT data. The second set of data indicates spatial and local distributions of impedance values and / or changes in impedance of areas of the heart in the thorax.Determination and provision of a second output signal based on the amount of data on EIT data and on the basis of the second amount of data. The second output signal indicates a current spatial position of a heart region in relation to areas of the lungs in the thorax.
    In the device for electroimpedance tomography (EIT) according to the invention, the implementation of the structure of the data processing described above takes place by means of a cooperation of a data input unit, a data output unit and a calculation and control unit with coordination of the calculation and control unit. The data input unit, the data output unit and the calculation and control unit are preferably together with the electrode arrangement, further units, such as units for signal detection, signal amplification, signal filtering, units for voltage supply, units for data exchange (interface) and data management (network) as an EIT system arranged with each other, but can also be connected and arranged as individual modules in a data network to form a cooperation. 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 the data and signals, and also adaptation elements, such as code or protocol -Conversion elements to adapt the signals and data for further processing in the calculation and control unit. The calculation and control unit has elements for data processing, calculation and sequence control, such as microcontrollers (µC), microprocessors (µP), signal processors (DSP), logic modules (FPGA, PLD), memory modules (ROM, RAM, SD-RAM) and combination variants thereof For example, in the form of an “embedded system”, which are designed and adapted to one another and configured by programming, to carry out the method for operating a device for electroimpedance tomography (EIT). The data output unit is designed to generate and provide the output signal.The output signal is preferably designed as a video signal (for example video out, component video, S-video, HDMI, VGA, DVI, RGB), on a wireless (WLAN, Bluetooth, WiFi) or wired (LAN, Ethernet) with the output unit. connected display unit or on the output unit itself, to enable a graphic, numerical or graphic representation.
    All of the advantages that can be achieved with the method described can be achieved in the same or similar manner with the described device for carrying out the method, and vice versa.
    The inventive device for determining a spatial position of a heart region in relation to areas of the lungs in the thorax has a data input unit, a calculation and control unit and a data output unit for determining a spatial position of a heart region in relation to areas of the lungs in the thorax , the deviceis configured by means of the data input unit to receive data and to provide a data set of EIT data,by means of the calculation and control unit for processing the amount of data on EIT data for determining a first amount of data with data which indicate spatial and local distributions of impedance values and / or impedance changes of areas of the lungs in the thorax and for processing the first amount of data and the amount of data of EIT data is designed to determine a first output signal which indicates a current spatial position of areas of the lungs in the thorax,by means of the calculation and control unit for processing the amount of data of EIT data for determining a second amount of data with data indicating spatial and local distributions of impedance values and / or impedance changes of areas of the heart in the thorax for processing the second amount of data and the Amount of data of EIT data for a determination of a second output signal, which is a current spatial position of a heart region in relation to areas of the lungs in the thorax, and is formedis designed to provide the first and second output signals by means of the data output unit.
    Signal values which indicate impedance values and / or changes in impedance from areas of the lungs in the thorax are often also referred to as ventilation-induced signals or ventilation-specific (VRIC = Ventilation Related Impedance Changes). Signal values which indicate impedance values and changes in impedance from areas of the heart in the thorax are often also referred to as heart-specific (CRIC = Cardiac Related Impedance Changes) signals.
    The determination of the first amount of data, which spatial and local distributions of the impedance values and / or changes in impedance of areas of the lungs in the thorax, based on the amount of data on EIT data can be done in the following way that signals or signal components which are due to the Frequency spectrum can be assigned to a range of typical respiratory frequencies can be extracted from the data set of EIT data. One possibility of extraction is made possible by the fact that the signal values in the EIT data, which indicate impedance values and / or impedance changes of areas of the lungs in the thorax (VRIC), have a signal amplitude that is an order of magnitude larger than the heart-specific signals (CRIC) and thus extraction of the ventilation-specific signal (VRIC) can be carried out, for example, by using threshold values. A suitable threshold value can be, for example, a value of 50% of the arithmetic mean of all signal values of the EIT data over a defined time course or a value of 50% of a global impedance curve. One possibility for obtaining the global impedance curve from the EIT data is described, for example, in US 2016 354 007 AA. As an alternative to such an extraction, signal filtering can also be used. For this purpose, for example, bandpass filtering with a passband from 0.1 Hz to 0.7 Hz can be used, alternatively or additionally, lowpass filtering with a cutoff frequency of approximately 0.8 Hz can be used in order to get signal components well above the typical frequency spectrum of the patient's breathability - For example, to hide frequency components in the area of the heartbeat in the area above approx. 1 Hz.
    The determination of the second amount of data based on the amount of data of EIT data can be carried out in the following way that signals or signal components which can be assigned to spectral signal ranges above typical respiratory frequencies with respect to the frequency spectrum are filtered out from the amount of data of EIT data by means of high pass filtering will. The cut-off frequency of the high-pass filtering is chosen such that the second amount of data essentially only has signals with signal components in the frequency spectrum of the cardiac activity. Adapted high-pass filtering with a cut-off frequency in the range of 0.8 Hz to 2 Hz can make this possible. For the limit frequency in a physiologically sensible range, for example, a frequency range above a characteristic frequency of 0.67 Hz can be selected for an adult, which corresponds to a heartbeat rate of 40 beats per minute. For the limit frequency in a physiologically sensible range, a frequency range above a characteristic frequency of 2 Hz can be selected for an approximately two-year-old child, which corresponds to a heartbeat rate of 120 beats per minute. An application with high pass / band pass filtering is in the scientific publication at Frerichs I, Pulletz S, Elke G, Reifferscheid F, Schadler D, Scholz J, Weiler N: "Assessment of changes in distribution of lung perfusion by electrical impedance tomography", respiration , 2009: Page 3-4, as with Vonk Noordegraaf A, Kunst PW, Janse A, Marcus JT, Postmus PE, Faes TJ, de Vries PM: "Pulmonary perfusion measured by means of electrical impedance tomography", Physiology Measurements, 1998 : Page 265-267. In addition to the previously described low, high or bandpass filtering in the frequency domain, the division of the amount of data of EIT data into the first and second amounts of data can also be done by averaging over a larger number of cardiac cycles. Alternatively, the division of the amount of data of EIT data into the first and second amounts of data can also be carried out with the aid of methods which are based on the use of a principal component analysis (PCA). An application of the main component analysis in connection with EIT data is in the scientific publication by Deibele JM, Luepschen H, Leonhardt S: "Dynamic separation of pulmonary and cardiac changes in electrical impedance tomography". Physiology Measurement, 2008: Pages 2 to 6.
    The amount of data on EIT data and the first and second amounts of data are preferably addressed in the form of an index-based manner and the data recorded on the EIT measurement channels, or impedance values, which areas, which areas of the lungs or Indexing areas of the heart are preferably addressed in the form of indexed vectors, indexed data fields or indexed matrices, stored and kept ready for further processing (vector operations, matrix operations). This indexing enables a spatially resolved assignment and addressing of individual data elements (pixels) or areas of a multiplicity of data points (ROI) of the data of the first and second data sets.
    [0035] The first output signal is determined by selecting the first data set as a subset of the data set of EIT data. The provision of the first output signal enables a representation or visualization of areas of the lungs, preferably in a transverse view, which shows the position, expansion of lung tissue in the patient's thorax, as well as changes in the position and expansion, and quantity and quality of ventilation (ventilation). of areas of the lungs with breathing gas during the course of ventilation alternating between inhalation and exhalation.
    [0036] The second output signal is determined by selecting the second data set as a subset of the data set of EIT data. This selection with determination of the second amount of data and automated identification of the heart region with the determination of the second output signal takes place after signal filtering has been carried out in such a way that the determination of the second amount of data is continued so that for an average signal of all impedance signals of all EIT picture elements ( Pixels) in the data set of EIT data or a subset of EIT picture elements (pixels) in the data set of EIT data, a power density spectrum is calculated. The heart rate in a characteristic frequency range is determined from this power spectrum, or the power distribution or amplitude distribution derived therefrom, using a robust methodology. The characteristic frequency range in a physiologically meaningful range for an adult is a range above a characteristic frequency of 0.67 Hz, which corresponds to a heartbeat rate of 40 beats per minute. For a child of about two years, for example, there is a characteristic frequency range in a physiologically meaningful range above a characteristic frequency of 2 Hz, which corresponds to a heartbeat rate of 120 beats per minute. A robust methodology is, for example, a parametric approach to an estimation using an autoregressive model, as described, for example, in a scientific paper by Takalo R .; Hytti H .; Ihalainen H .: "Tutorial on Univariate Autoregressive Spectral Analysis", Journal of Clinical Monitoring and Computing, 2005, 19: pages 402-404. The type of signal processing, in particular the selection of the spectral analysis or pass / cut-off areas of filters, can be derived from the data set with information relating to the at least one heart function, in particular based on the heartbeat rate or the pulse rate of the heart, since typical Differentiate heart rates from typical respiratory rates by a factor of four to five. The heart rate can be determined from the amount of EIT data to determine the heart region in a particularly advantageous manner with the aid of a so-called Kalman filter. The functioning of a Kalman filter and its effects and advantages in signal processing are in the scientific paper by Kalman RE,: "A new Approach to Linear Filtering and Prediction Problems", Transaction of the ASME, Journal of Basic Engineering, 1960, 82: pages 35 - 45 described. Electroimpedance tomography often results in signal disturbances, for example caused by movement on the body, easy self-breathing, simultaneous use of computer tomography, which occur uncorrelated with the measurement signals. Without the use of suitable filtering, false positive detections of blood volume pulses could occur. The Kalman filter is well suited for removing interference signals of this type and for providing a stable heart rate signal. The Kalman filter provides an output signal converging against the undisturbed value - with an increase in the number of measured values, the expected value of which corresponds to that of the undisturbed signal, the variance of which is minimized. The heart region is determined on the basis of the determined power distribution in the characteristic frequency range. The determination is made by selecting a region around the area of the maximum of the power or amplitude distribution, because the heart region is located in this region around the area of the maximum of this distribution. When determining the second amount of data, an additional criterion can be used in an optional and advantageous manner in addition to the power or amplitude distribution. This additional criterion requires that only signals of the same phase position in the second data set are used to determine the heart region. This gives the advantage of an improved robustness of the data processing when determining the heart region. The current spatial position of the heart region in relation to areas of the lungs in the chest is thus identified and can serve as the basis for the second output signal, which indicates the current spatial position of the heart region in relation to areas of the lungs in the chest. The provision of the second output signal enables, for example, a representation or visualization of the heart region, which illustrates the position and extent of the heart in the patient's thorax.
    The use of the subset selected as the first data set from the EIT data, taking into account the actual current heart region by means of the second output signal for display or visualization as an EIT image of the thorax, in contrast to using the entire data set of EIT data the advantage that the interpretability of the EIT image is not made more difficult by the movements of the spatial position of the heart induced by the breathing movements.
    The embodiments described below represent variations, variants of data processing, the sequence of steps of the inventive method for operating a device for electroimpedance tomography (EIT), as well as the tasks of the calculation and control unit in the inventive device for electroimpedance tomography (EIT ) can add or expand. With regard to the disclosures, these embodiments described below are therefore also to be understood as extensions of the functional scope, in particular the calculation and control unit of the device for electroimpedance tomography (EIT) according to the invention. The advantages described for the method according to the invention can be achieved in the same or in a similar way with the device for carrying out the method according to the invention and the described embodiments of the device. Furthermore, the described embodiments and their features and advantages of the method can be transferred to the device, just as the described embodiments of the device can be transferred to the method. The data set of EIT data has signals or data associated with at least one plurality of electrodes arranged in a horizontal plane around the thorax.
    In a particular embodiment, the amount of data on EIT data can also have signals or data from at least two multiplicity of electrodes spaced parallel to one another at a defined distance.
    [0040] In a preferred embodiment, a determination of a position of an electrode arrangement on the thorax of a patient is provided. In particular, a determination of a vertical position of the electrode arrangement on the thorax is provided. The electrode arrangement can be designed, for example, as an electrode belt, which - in size and length adapted to the individual thoracic circumference of the respective patient - optimally at the height of the fourth to sixth costal arch (ICS 5) - in the area of the fourth to sixth intercostal space (intercostal space = ICS), (ICS 4 to ICS 6) can be attached around the patient's chest. The position of the electrode arrangement on the patient's thorax is determined on the basis of the third amount of data. In this preferred embodiment, the calculation and control unit is designed to determine and provide a control signal which indicates the position of the electrode arrangement on the patient's thorax. The control signal is determined on the basis of the determined position of the heart. The control signal can be used to give a user a visual, acoustic or visual indication of whether the electrode arrangement is properly positioned on the patient's thorax or not. When properly positioned on the circumference of the chest as part of the data set of EIT data, the second data set, which indicates spatial and local distributions of the impedance values and / or impedance changes of areas of the heart in the chest, is present in a certain order of magnitude. In the case of improper positioning, for example closer to the circumference of the abdomen, the second amount of data, which indicates spatial and local distributions of the impedance values and / or changes in impedance of areas of the heart in the thorax, is not available in a specific order of magnitude. For example, the position of the electrode arrangement on the patient's thorax can be determined by referring to an EIT image, which shows the current state of areas of the lungs and heart in the thoracic space both based on data from the first amount of data and data from the second amount of data depicts quantitative ratios in the data volumes or area ratios in the EIT image between the first data volume and the second data volume are evaluated using a comparison variable. For example, an area equivalent of less than 10% of the second amount of data - indicating the area of the heart - to the first amount of data - indicating the lung - could be used as an indication that the electrode arrangement is not correctly positioned, i.e. not on the circumference of the chest, but on the circumference of the abdomen . The control signal can also be used for output to a display unit which is directly or indirectly connected to the EIT device, and forwarded to a data network (LAN, WLAN, PAN, cloud).
    In a further preferred embodiment, the calculation and control unit is designed to carry out a continuous determination of the second amount of data and to take into account the second amount of data with data which show the spatial and local distributions of the impedance values and / or impedance changes of areas of the heart in the chest indicated to perform the data processing of the temporally following and continuously provided EIT data by the calculation and control unit. The calculation and control unit is designed to determine the first quantity of data with data that indicates spatial and local distributions of impedance values and / or impedance changes in areas of the lungs in the thorax, the previously determined second quantity of data with data that describes the spatial and local distributions of the impedance values and / or changes in impedance of areas of the heart in the thorax are indicated or the current spatial position of the heart region in relation to the areas of the lungs in the chest must be taken into account. Possible configurations of such considerations are, for example, fading out of data or also markings, for example implemented as masking of data. The data belonging to the second data set are marked, masked or masked out by the calculation and control unit in the data set of the EIT data in order to be used for image reconstruction, for calibrations during commissioning or for recalibrations during operation Repositioning of the patient, repositioning of the belt may be necessary to take into account. Masking within the EIT data or masking out partial quantities of EIT data can take place both in the form of disregarding the relevant EIT data, alternatively masking or masking out the corresponding EIT data by means of substitute data, for example data from neighboring areas, respectively. In this case, the masked subsets can advantageously be copied into a further data set or the remaining, non-hidden data can be copied into a further data set. Because impedance changes in the heart region induced by the shifting of the heart in the cycle of breathing or ventilation lose influence on this reference variable due to the masking, the masking can be advantageous for the determination of reference variables, for example for the global impedance curve calculated from the EIT data -so the sum of the relative impedance changes over both areas (left lung, right lung) of the lungs - or also for regional impedance curves -so the sum of impedance changes within selected regions (ROI, regions of interest) of individual areas of the lungs within the thorax, if on the basis of these reference values during operation of the device for electroimpedance tomography (EIT) then further determined parameters can be determined with improved accuracy. This marking, masking or masking can then be used to display the functional EIT representations for ventilation, but also parameters derived therefrom, such as intratidal redistribution (ITV), regional ventilation delays (RVD), into which the global impedance curve and / or the regional impedance curves are used as reference values or mean values, experience improvements in the meaningfulness and accuracy of the information, since subsets with data belonging to the heart region are not considered as ventilation-synchronous impedance changes in areas of the heart region with the global impedance curve or regional impedance curves of certain areas (ROI), such as also go into other derived parameters (e.g. RVD, ITV). In addition, representations regarding the perfusion of the lungs and the pulsation of the lungs can thus experience improvements in the meaningfulness and accuracy of the statements. In principle, a large number of the functional EIT images with representations of ventilation, pulsatility and perfusion benefit from the possibilities of marking, masking or masking out the EIT data given by the present invention.
    In a further preferred embodiment, data processing and / or signal filtering can be carried out on the basis of the second amount of data for the temporally subsequently provided EIT data. Adjustments to the cutoff frequency of the high-pass filtering can be derived from the frequency ranges of the cardiac activity that can be determined from the second data set. For example, at the beginning, or after a high-pass pre-filtering, for example in a frequency range from approx. 0.5 Hz to 1 Hz, a finer filtering can then be adapted to the range of the current heart rate in the further course of the data processing each patient.
    [0043] In a further preferred embodiment, the determined position of the heart region can be taken into account in a visualization of the EIT data.It is thus possible, preferably in a transversal view of the lungs, to show the heart as an area in a highlighted manner. This is possible, for example, through different shades of gray, color or pattern of areas of the heart and areas of the lungs.
    In a further preferred embodiment, information relating to the heart rate from external data sources, such as a physiological patient monitor, a blood pressure measuring device, a measuring device for measuring oxygen saturation (SPO2), an EKG measuring device or a diagnostic device, cardiography device or plethysmography -Device, which in some way provides a signal or data indicating or including a heart rate, can be used to adapt the cut-off frequency of the high-pass filtering.
    The embodiments described, both individually and in combination with one another, relate special configurations of the electro-impedance tomography device according to the invention and the method for electro-impedance tomography according to the invention for determining a spatial position of a heart region in the region of the thorax to areas of the lungs of a patient. Advantages and further embodiments resulting from a combination or combinations of several embodiments are nevertheless also covered by the inventive concept, although not all possible combinations of embodiments are detailed in each case. The above-described embodiments of the method according to the invention can also be designed in the form of a computer-implemented method as a computer program product with a computer, the computer being prompted to carry out the above-described method according to the invention when the computer program is on the computer or on a processor of the computer or a so-called "embedded system" as part of a medical device, in particular the EIT device. The computer program can also be stored on a machine-readable storage medium. In an alternative embodiment, a storage medium can be provided, which is intended for storing the above-described, computer-implemented method and can be read by a computer. It is within the scope of the present invention that not all steps of the method necessarily have to be carried out on one and the same computer instance, but they can also be carried out on different computer instances, for example in a form of cloud computing described in more detail above. The sequence of method steps can also be varied, if necessary. Furthermore, it is possible that individual sections of the method described above in a separate, for example self-salable unit, such as on a data evaluation system preferably located in the vicinity of the patient, 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 room designed to monitor several patient rooms, so to speak as a distributed system.
    The present invention will now be explained in more detail with the aid of the following figures and the associated figure descriptions without restricting the general inventive concept.
    [0047] The figures show:1 shows a schematic illustration of an arrangement of an EIT device with an electrode arrangement,<tb> <SEP> FIGS. 2a, 2b arrangements of the electrodes according to FIG. 1,<tb> <SEP> FIGS. 3a, 3b representations of visualizations according to FIGS. 2a, 2b,<tb> <SEP> FIG. 4 shows another visualization,<tb> <SEP> Figures 5, 6 are schematic representations of a flow chart for determining a heart region with determination of an electrode position.
    Figure 1 shows a schematic representation of a device 10 for processing EIT data 3 from an EIT device 30 and an electrode arrangement 33 with a plurality of electrodes E1, ... En33 '. The electrode arrangement 33 with the electrodes E1,... En33 'is arranged on the upper body (thorax) 34 of a patient 35. A measurement value acquisition and feed-in unit 40 is designed to feed a signal, preferably an alternating current (current feed) or also an alternating voltage (voltage feed), to a pair of electrodes 33 ′ in one measurement cycle. The voltage signals resulting from the alternating current feed-in (current feed-in) are detected as signals at the remaining electrodes 33 ′ by the measured value acquisition and feed-in unit 40 and are provided to the data input unit 50 as EIT data 3. The EIT data 3 provided are supplied to a control unit 70 in the EIT device 30 via a data input unit 50. In the control unit 70, a data memory 77 is provided, which is designed to store a program code. The sequence of the program code is coordinated by a microcontroller, which is arranged as an essential element in the control unit, or another configuration of computing elements (FPGA, ASIC, µP, µC, GAL). The billing and control unit 70 is thus prepared and provided to coordinate the operation of the EIT device 30 and to carry out the illustrated steps with comparison operations, arithmetic operations, storage and data organization of the data quantities. By means of a data output unit 90, the values determined by the control unit 70 are brought to a visualization 900 on a display device 95. In addition to the visualization 900, further elements 99 'are also present on the display device 95, for example control elements 98, elements 99 "for displaying numerical values or elements 99' for displaying time profiles or curves.
    FIGS. 2a and 2b show representations of different arrangements of the electrode arrangement 33 on the thorax 34 according to FIG. 1. The same elements in FIGS. 1, 2a, 2b are designated by the same reference numbers in FIGS. 1, 2a and 2b. FIG. 2a shows a first arrangement of the electrode arrangement 33 and electrodes 33 'on the thorax 34 according to the schematic illustration according to FIG. 1 in a horizontal normal position 36. FIG. 2b shows a second arrangement of the electrode arrangement 33 and electrodes 33' on the thorax 34 according to the schematic Representation according to Figure 1 in a horizontal position 36 '. A horizontal deviation 37 is shown between the normal position 36 and the deviating position 36 '.
    Figures 3a and 3b show representations of visualizations according to the arrangements according to Figures 2a and 2b. Identical elements in FIGS. 1, 2a, 2b, 3a, 3b are designated in FIGS. 1, 2a, 2b, 3a and 3b with the same reference numbers. In FIGS. 3a and 3b there are currently visual representations 903a, 903b of the visualization 900 (FIG. 1) associated with positions 36, 36 'of the electrodes 33, 33' on the thorax 34 according to FIGS. 2a and 2b on the display device 95 (FIG 1). The effects of different vertical positions 36, 36 'of the electrodes 33, 33' on the thorax 34 on the visualization 900 (FIG. 1) are shown in the visual representations 903a, 903b. 3a and 3b show in the visual representations 903a, 903b in a transverse view and in a schematic manner the heart region 93, 93 'and lung regions 97, 97'. Here, as an optional embodiment of the elements 99, 99 ', 99 "(FIG. 1) of the display device 95 (FIG. 1), in a separate symbolic representation 800, in addition to the visualization 900 (FIG. 1), graphic representation elements 801a, 801b are shown - for example in the form of Arrows 802a, 802b - arranged, which are intended to symbolize the current positions 36, 36 'of the electrode arrangement 33 on the thorax 34, or the necessary corrections of the electrode arrangement 33 on the thorax 34. In addition, an output field 803 is provided, which is provided to the user - in addition to the arrow representations 802a, 802b - a textual note with regard to a correct attachment - according to FIGS. 2a and 3a - of the electrode arrangement 33, 33 'on the thorax 34, or an incorrectly, ie too low attachment - according to FIGS. 2b and 3b - to provide the electrode arrangement 33, 33 'on the thorax 34. In this output field 803, for example, the horizontal deviation 37 can be given to the user for orientation, additional information or suggestions for action can also be given.
    4 shows two different variations 904, 904 ', 904 "of representations of visualizations 900 (FIG. 1) of EIT images without and taking into account a position of the heart region in relation to areas of the lungs. Same elements in the figures 1, 2a, 2b, 3a, 3b, 4 are given the same reference numerals in Figures 1, 2a, 2b, 3a, 3b and 4. The illustration 904 shows an EIT image 940 of areas of the lungs in which the heart region The representation 904 'shows an EIT image 940', in which the heart region was included in the configuration of the representation by the image regions (pixels) associated with the heart region in this EIT image 940 ' the areas of the lungs are shown as areas without any information, ie the corresponding areas are “hidden” in EIT image 940 '. In illustration 904 "are the image areas (pixels) which belong to the heart region as an independent image area 940 ", which is separated from areas of the lungs.
    FIG. 5 shows a flow chart which shows a flow 1 for processing data 3 obtained using an electroimpedance tomography device (EIT) 30 (FIG. 1) for determining a spatial position of a heart region in relation to areas of the lungs in the chest of a patient. Identical elements in FIGS. 1, 2a, 2b, 3a, 3b, 4, 5 are identified in FIGS. 1, 2a, 2b, 3a, 3b, 4 and 5 with the same reference numbers.The processing is shown on the basis of a sequence of steps 1, which begins with a start 100 and ends with a stop 999.In a first step 11, a data set 300 of EIT data 3 is made available.In a second step 21, on the basis of the data set 300 of EIT data 3, a first data set 400 with data 4, which indicates spatial and local distributions of the impedance values and / or impedance changes of areas of the lungs in the thorax 34 (FIG. 1), is determined. In the second step 21, a first output signal 400 'is also provided on the basis of the data quantity 300 of EIT data 3 and on the basis of the first data quantity 400, which indicates a spatial position 44 of areas of the lungs in the thorax 34 (FIG. 1) . The first amount of data 400 is determined on the basis of the signal values, which indicate impedance values and / or changes in impedance from areas of the lungs in the thorax 34 (FIG. 1), on the basis of data extraction or data filtering from the amount of data 300 of EIT data 3. The data extraction can for example on the basis of an amplitude evaluation or by means of a threshold value comparison of the signal amplitudes of the EIT data 3, which is made possible by the fact that the signal values in the EIT data 3 which indicate impedance values and / or impedance changes of areas of the lungs 97 (FIG. 4), have an order of magnitude larger signal amplitude than the heart-specific signals. An alternative possibility arises from the use of frequency-specific signal filtering, for example with low-pass filtering with a cut-off frequency above 0.8 Hz (adult) or above 2 Hz (small child). It should be noted that due to the rhythmic filling and emptying of the lungs with breathing gases and the movement and displacement of the heart relative to the lungs and within the thorax 34 (FIG. 1), areas in the thorax 34 (FIG 1) are represented, in which impedance changes caused directly by the rhythmic alternation of inhalation and exhalation are given by ventilation-induced changes in state, but areas cannot be distinguished from those in which ventilation-synchronous impedance changes are caused by spatial displacements of the lungs and heart. When using this first output signal 400 'for a visual output of an EIT image with representation of the spatial position 44 of the lungs in the thorax 34 (FIG. 1), the areas of the heart are in the thorax 34(Figure 1) cannot yet be differentiated. This requires a further analysis, as is continued in the further, third step 31.In a third step 31, on the basis of the data amount of EIT data, a second data amount 500 is determined, which indicates spatial and local distributions of impedance values 5 and / or impedance changes 5 'of areas of the heart in the thorax 34 (FIG. 1). In the third step 31, on the basis of the amount of data 300 of EIT data 3, and on the basis of the second amount of data 500, a second output signal 500 'is provided, which has a spatial position 55 of the heart in relation to the areas 44 of the lungs in the thorax 34 (Figure 1) indexed. The determination of the second data set 500, which indicates spatial and local distributions of the impedance values 5 and / or impedance changes 5 'of areas of the heart in the thorax 34 (FIG. 1), can be carried out, for example, by means of an adapted high-pass filtering of the data set 300 of EIT data 3 a limit frequency in the range of 0.8 Hz to 2 Hz.In an optional fourth step 41, based on the data set 300 of EIT data 3 and on the basis of the second data set 500, a further data set 600 is determined which has a position 36, 36 'of the electrode arrangement 33 on the patient's thorax 34 (FIG. 1) 35 (Figure 1) indexed. In the optional fourth step 41, a control signal 600 'is provided on the basis of the further amount of data 600, which indicates the position 36, 36' of the electrode arrangement 33 on the thorax 34 (FIG. 1).
    FIG. 6 shows a flowchart which shows a flow 1 'for processing data 3 obtained by means of an electroimpedance tomography device (EIT) 30 (FIG. 1) for determining a spatial position of a heart region in relation to areas of the heart Lungs in the chest 34 (Figure 1) of a patient shows. Identical elements in FIGS. 1, 2a, 2b, 3a, 3b, 4, 5, 6 are denoted in FIGS. 1, 2a, 2b, 3a, 3b, 4, 5 and 6 with the same reference numbers.The processing is shown on the basis of a sequence of steps 1 'which begins with a start 100' and ends with a stop 999 'and is largely identical to the sequence 1 described for FIG. This sequence 1 'according to this FIG. 6 is expanded compared to the sequence 1 of FIG. 5 in such a way that on the one hand the data provision of the EIT data 3, as well as the data processing (step sequence 11, 21, 31) with determination of the first amount of data (400) and second data set (500) and the output signals associated with these data sets (400 ', 500') and the determined areas of lung 44 and the determined spatial position of the heart 55 are continuously continuous in time. This is illustrated by the return branch 1000 from stop 900 'to start 100' in FIG. 6.A further expansion of the sequence 1 'compared to the sequence 1 (FIG. 5) results in the fact that in the continuous provision of data and data processing, the second quantity of data 500 of the quantity of data 300 provided is provided with EIT data 3. This is illustrated by signal path 551 in FIG. 6. The second data set 500 can thus be used to mark, mask or hide subsets in the data set of EIT data 3, in order to continuously improve representations of areas of the lungs 44 by blanking out the heart region 55 in the further course of time of the EIT application 'derived from the EIT data 3 and displayed on a display device (Figure 1) and, on the other hand, to determine some parameters, such as the global impedance curve common in the EIT with improved accuracy. The improved accuracy of the global impedance curve results from the fact that ventilation-synchronous impedance changes in areas of the heart region 55 cannot be included in the calculation of the global impedance curve by the calculation and control unit 70 (FIG. 1). The statements made with regard to the global impedance curve also apply in a comparable manner to other parameters, such as RVD, ITV and representations 900 (FIG. 1) of ventilation, pulsatility and perfusion. The optional fourth step 41 shown in FIG. 5 and the resulting data volume 600 and control signal 600 'are not shown in FIG. 6 for reasons of clarity.
    REFERENCE SIGN LIST
    1 sequence 3 EIT data 4 impedance values of areas of the lung 4 'impedance changes of areas of the lung 5 impedance values of areas of the heart 5' impedance changes of areas of the heart 10 device for processing EIT data 11, 21, 31, 41 Steps in sequence 1, 30 EIT device 33 electrode arrangement 33 'electrodes 34 thorax 35 patient 36 electrode arrangement on the thorax in a normal position 36' electrode arrangement in a position close to the abdomen 37 distance, vertical position deviation 40 measurement value acquisition and feed unit 44 areas of the lungs 44 'areas of Lung, improved representation 55 spatial position 55 of the heart 50 data input unit 70 control unit, calculation / control unit, μC 77 data memory 90 data output unit 93, 93 'heart region 95 display device 97, 97' lung regions 98 control elements 99, 99 ', 99 "elements of display device 95 100, 100 'START 300 amount of data on EIT data 400 first amount of data 400' first output esignal 500 second data volume 500 'second output signal 551 signal path 600 further data volume 600' control signal 800 graphic representation 801a, 801b position of the electrode arrangement on the thorax 802a, 802b symbolic representation, arrows 803 output field 900 visualization 904, 904 ', 904 "representations EIT picture 940 , 940 ', 940 "screen areas in EIT screen 999, 999' STOP 1000 return
    权利要求:
    Claims (16)
    [1]
    1. The device (1) for determining a spatial position (55) of a heart region in relation to areas of the lungs (44) in the thorax (34)- a data input unit (50),- a calculation and control unit (70),- a data output unit (90),- The device (1) is designed by means of the data input unit (50) to receive data (3) and to provide a data volume (300) of EIT data (3),- The device (1) by means of the calculation and control unit (70) for processing the amount of data (300) of EIT data (3) for determining a first amount of data (400) with data showing spatial and local distributions of impedance values (4) and / or changes in impedance (4) of areas of the lungs in the thorax (34) are formed,- The device (1) by means of the calculation and control unit (70) for processing the first amount of data (400) and the amount of data (300) of EIT data (3) for determining a first output signal (400 '), which a current spatial position of areas of the lungs (97) is indicated in the thorax (34),- The device (1) is designed by means of the data output unit (90) to provide the first output signal (400 ',- The device (1) by means of the calculation and control unit (70) for processing the amount of data (300) of EIT data (3) for determining a second amount of data (500) with data showing spatial and local distributions of the impedance values (5) and / or changes in impedance (5 ') of areas of the heart (93) in the thorax (34) is formed,- The device (1) by means of the calculation and control unit (70) for processing the second data set (500) and the data set (300) of EIT data (3) for determining a second output signal (500 '), which a current spatial position of a heart region (55) in relation to areas of the lungs (44) in the thorax (34) is indicated, developed and- The device (1) is designed to provide the second output signal (500 ') by means of the data output unit (90).
    [2]
    2. The device (1) according to claim 1, wherein the amount of data (300) of EIT data (3) signals or data associated with at least one plurality of electrodes (33, 33 ') arranged in a horizontal plane around the thorax (34). ) having.
    [3]
    3. Device (1) according to claim 1, wherein the amount of data (300) of EIT data (3) signals or data from at least two, parallel to each other at a defined distance spaced plurality of electrodes (33, 33 ').
    [4]
    4. Device (1) according to one of the preceding claims, wherein the calculation and control unit (70) is designed, on the basis of the first data set (400) and the second data set (500), a position of an electrode arrangement (33, 33 ') on Determine the thorax (34) of a patient (35), in particular a vertical position of the electrode arrangement (33, 33 ') on the thorax (34) of the patient (35).
    [5]
    5. The device (1) according to one of the preceding claims, wherein the calculation and control unit (70) is designed to continuously determine the second amount of data (500) from the EIT data (3), and wherein the calculation and control unit ( 70) is further configured to take the second data quantity (500) into account when processing the temporally subsequent EIT data (3).
    [6]
    6. The device (1) according to claim 5, wherein the calculation and control unit (70) is designed to mark, mask or based on the second data set (500) subsets in the data set (300) of EIT data (3) hide.
    [7]
    7. The device (1) according to claim 6, wherein the calculation and control unit (70) is designed to copy the marked or masked subsets from the data set (300) of EIT data (3) into a further data set.
    [8]
    8. The device (1) according to claim 6, wherein the calculation and control unit (70) is designed to copy the non-hidden subsets from the data set (300) of EIT data (3) into a further data set.
    [9]
    9. The device (1) according to any one of claims 5 to 8, wherein the calculation and control unit (70) is designed in the calculation of the global impedance curve and / or in the calculation of regional impedance curves based on the amount of data (300) provided on EIT - Data (3) to take into account the second data set (500), the marked or masked subsets or the hidden subsets.
    [10]
    10. The device according to one of claims 5 to 9, wherein the calculation and control unit (70) is designed to adapt data processing and (or signal filtering based on the second amount of data (500), the calculation and control unit (70) the adaptation of the data processing and / or signal filtering takes into account the frequency ranges of the cardiac activity that can be determined from the second data set (500).
    [11]
    11. The device according to claim 10, wherein the data input unit (50) is designed to read information relating to the heart rate from external data sources and to provide the calculation and control unit (70) for adapting the data processing and / or signal filtering.
    [12]
    12. Device according to one of the preceding claims, wherein the calculation and control unit (70) in cooperation with the data output unit (90) is formed, the determined position of the heart region (93) in a visualization (900) of the EIT data (3) to consider.
    [13]
    13. Method for operating a device (1) designed according to the previous device claims, wherein after a data quantity (300) of EIT data (3) has been made available, a determination is made on the basis of the data quantity (300) of EIT data first data set (400) of spatial and local distributions of impedance values (4) and / or impedance changes (4 ') of areas of the lungs in the chest (34) and a determination of a second data set (500) of spatial and local distributions of impedance values (5 ) and / or changes in impedance (5 ') of areas of the heart (93)in the thorax (34).
    [14]
    14. Method for determining a spatial position (55) of a heart region (55) in relation to areas of the lungs (44) in the thorax (34) with a sequence of the following steps (11, 21, 31):- Provision of a quantity of data (300) of EIT data (3),- Determination of a first amount of data (400) with data indicating spatial and local distributions of impedance values (4) and / or impedance changes (4 ') from areas of the lungs in the thorax (34) on the basis of the amount of data of EIT data,- Determination and provision of a first output signal (400 '), which indicates a current spatial position of areas of the lungs (97) in the thorax (34) based on the amount of data (300) of EIT data (3) and on the basis of the first amount of data (300),- Determination of a second amount of data (500) with data indicating the spatial and local distributions of the impedance values (5) and / or changes in impedance (5 ') of areas of the heart (93) in the thorax (34) based on the amount of data (300)on EIT data (3),- Determination and provision of a second output signal (500 '), which indicates a current spatial position of a heart region (55) in relation to areas of the lungs (44) in the thorax (34) based on the amount of data (300) of EIT data, and based on the second amount of data (500).
    [15]
    15. The method according to claim 13 or claim 14, wherein the data set (300) of EIT data (3) comprises signals or data from at least one plurality of electrodes (33, 33 ') arranged around the thorax (34).
    [16]
    16. The method according to claim 13 or 14, wherein the amount of data (300) of EIT data (3) signals or data from at least two, parallel to each other at a defined distance spaced plurality of electrodes (33, 33 ').
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    法律状态:
    优先权:
    申请号 | 申请日 | 专利标题
    DE102018008545.8A|DE102018008545A1|2018-11-01|2018-11-01|Device and method for electro-impedance tomographywith determination of a heart region|
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