CN1145213A - Harmless quantitative diagnosis system for cardiovascular disease and its use - Google Patents

Harmless quantitative diagnosis system for cardiovascular disease and its use Download PDF

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CN1145213A
CN1145213A CN 96107979 CN96107979A CN1145213A CN 1145213 A CN1145213 A CN 1145213A CN 96107979 CN96107979 CN 96107979 CN 96107979 A CN96107979 A CN 96107979A CN 1145213 A CN1145213 A CN 1145213A
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patient
case history
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CN1095354C (en
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郑筱祥
张恒义
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Zhejiang University ZJU
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Abstract

A diagnosis system for quantitatively diagnosing cardiovascular disease without trauma is composed of eyeground camera, video camera, microcomputer, multimedia card, network communication interface, laser printer, magnetic tape driver, R/W optical disk driver and software. Its basic functions include basic information input, sampling eyeground image, image processing, parameter measuring, display and analysis, printing result and demanstrating eyeground spectrum.

Description

A kind of cardiovascular diseases's harmless quantitative diagnosis system and using method thereof
The invention belongs to the medical diagnosis on disease Apparatus and operation method, relate to the computer system apparatus of diagnosing cardiovascular and cerebrovascular disease.
Cardiovascular and cerebrovascular disease is aging population death and major cause of morbidity in the world, and is wherein common with coronary heart disease, hypertension, arteriosclerosis, cerebral hemorrhage etc.The forming process of these diseases shows as morphosis and the asymptotic variation of histiocyte on tiny blood vessels, develop into organic disease at last and cause disease to be sent out.Therefore, this type of disease had significantly change on microvascular morphosis before making a definite diagnosis with conventional method.So by analysis, not only can diagnose the generation and the lesion degree thereof of this class disease, and can forecast the generation sign of this type of disease the blood capillary morphosis, significant clinically.The optical fundus retinal vessel is the small artery and the venule blood vessel of the unique energy of human body direct observation, and it is in body interior, is not subjected to external interference.The particularly important is, not only retinal vessel is consistent with the variation of whole body blood vessel, and retinal vessel and cerebral vessels belong to last blood vessel eventually together, and character is very similar, and the pathological changes of retinal vessel is also similar with the pathological changes of cerebral vessels.Analyze the pathological change of optical fundus retina and blood vessel thereof, can provide important evidence for the diagnosis of cardiovascular and cerebrovascular disease.So, observe optical fundus retina and blood vessel thereof, diagnosable general ophthalmic, the also general cardiovascular disease of diagnostic analysis qualitatively, but diagnosis of cardiovascular diseases quantitatively.
The objective of the invention is will be at prior art problems, a kind of computer system apparatus with the diagnosis of optical fundus blood vessel image analysis is provided, use it to carry out AT physical examination to the people who suffers from cardiovascular and cerebrovascular disease, can do the quantitative Diagnosis analysis cardiovascular disease to health.
For achieving the above object, having adopted with the microcomputer is the system and device of core component, and it has comprised the optical fundus microscopic camera that is used to obtain fundus photograph; Fundus photograph is converted into gamma camera, multimedia card or the scanner of digital image; Be used for the microcomputer of system's control and information processing and be used for streamer tape device or the erasable optical disk driver that the centralized backup patient history writes down.
The using method of this device is to take fundus photograph with the optical fundus microscopic camera, by gamma camera, multimedia card or scanner photo is digitized into the computer digit image under system program control, and forms patient's multimedia case history framework in computer; In microcomputer, digital image is handled, the characteristic parameter of disease is measured and analyzed, disease is carried out auxiliary diagnosis, and print result's report by computer.
The concrete operations step is as follows: (1) starts this computer working, the display system main menu.Main menu is provided with four autonomous graphic buttons, and analysis of medical record, collection of illustrative plates demonstration, system specialization are carried out in selection respectively according to custom menu, four feature operations log off.(2) if select the analysis of medical record menu option, then start the analysis of medical record program.In this program, have four function of tonic chord items to select for the user: new patient's image acquisition, patient history analysis, patient history is checked, is quit a program.(3) if the user selects new patient's image acquisition option, program requires to import patient's essential information in the dialog box mode: name, age, sex, used amplification visual angle when fundus photograph is taken, check a left side/right eye, when the user confirmed that input is finished, the information of program read-in input was also carried out error checking, after checking that input is errorless, create patient's multimedia case history document framework, and write patient's essential information.Start the image acquisition function, circle collection patient five images, determine to gather image in the quadrant position on optical fundus (on the nose, under the nose, on the temporo, under the temporo in the dialog box mode by the user, central authorities), and according to user's choice of location and patient's the visual filename of essential information generation, select measured zone in the image with removable window by the user, only this measured zone image subsection is saved in the image file, simultaneously image name is kept in the patient history, and puts the image processing surveying marker and be the measurement of being untreated.(4) if the user selects patient history to analyze menu item, start the patient history analytic function, select to have existed the patient name of multimedia case history to carry out analysis of medical record with the combination dialog box.According to the patient name of selecting, open patient's multimedia case history file, read in patient's essential information and image acquisition information, handle metrical information.Select to handle the image of measurement by the user with the dialog box mode.
With the image of the pending measurement visual relief area of packing into, carry out the image processing conversion according to the image processing pattern that the user selects, and the result is write visual relief area cover former image.(5) the visual enterprising line parameter after processing is measured.The parameter of measuring is selected by the user, and patient's multimedia case history structure is transmitted in control module and each parameter measurement intermodule with pointer in the internal memory, after each parameter measurement, measuring position information, measurement result is write in the case history structure.
Measurable parameter comprises following project:
The artery and vein caliber compares parameter measurement, movably producing a parallel lines cursor (‖) in the measurement window, this cursor can arbitrarily move on image according to the position of user's input, the user rotates arbitrarily in the plane with the deflection of rolling thick stick input, and the user adjusts the size of parallel lines spacing arbitrarily with rolling thick stick input value.Live the blood vessel outward flange with the light ticket holder, can read the diameter of blood vessel.Parameter can be according to the customer requirements repeated measurement, five times at the most, gets its meansigma methods as final measurement.
Semi-automatic measuring: make parallel lines cursor and blood vessel center line parallel in the measurement window, and be slightly larger than blood vessel diameter, select to measure automatically button, system detects the edge of blood vessel automatically, calculates the caliber of tested blood vessel.
The arterial bifurcation parameter measurement produces a Y shape and measures cursor in removable measurement window, each branch of cursor all can change diameter and direction.When cursor overlaps with the arteries branch, can obtain each branched caliber of tremulous pulse, caliber ratio, branch angle.
The reflective parameter measurement of tremulous pulse axis produces parallel lines and measures cursor (‖) in removable measurement window, make this cursor be parallel to the arteries centrage and greater than blood vessel diameter, after selecting to determine key, read vascular cross-section gray scale numerical value, calculate radially shade of gray of blood vessel, with the outward flange of the minimum and maximum value of gradient position as blood vessel, analyze with parameter, determine the outward flange of blood vessel and the edge of the interior reflective tape of blood vessel, calculate the blood vessel diameter of tremulous pulse, the width of axis reflective tape, the reflective width ratio of reflective tape width and blood vessel diameter, the intensity of light reflection of the maximum gray scale of reflective tape and vessel boundary gray scale compares etc.
The parameter measurement of artery and vein impression in measurement window movably, produce one intersect linear cursor (
Figure A9610797900101
), overlap with the vein center line with the tremulous pulse that intersects respectively with two lines of this cursor, obtain the angle of the crossing, with the measuring position, the artery and vein relative position is judged in people-machine dialogue, further does the artery and vein taper measurement, differentiates the impression degree according to above parameter result.
The retinal hemorrhage area measurement is followed the tracks of at hemorrhage regional surrounding edge with mouse, and is filled this hemorrhage zone in measurement window movably, measures the area and the girth in hemorrhage zone.Can measure ten zones simultaneously.
Finish this image parameter and measure, return and handle image selection dialog box, carry out the processing and the parameter measurement of next images.(6) finish in the customer analysis measurement, select to withdraw from operation, withdraw from this patient's analysis of medical record after, Automatic Program enters case history printing function state.The function selecting that shows printer, the user begins to print the case history report after confirming that printer setup is correct.According to the information in the multimedia case history structure, print the System Reports list that contains patient's essential information, measures image, measurement result, measuring position and computer aided diagnosis results according to WINDOWS graphics device mode.(7) if the user selects case history inquiry menu item in the main menu of analysis of medical record program, program enters case history query function module.Show case history query function interface.Select patient, the position image that to check and the parameter that will check in combination controller chassis mode by the user.Behind user's setting check, open the multimedia case history file of given patient and with medical record information structure graftabl.Pack in the multimedia card DRAM zone of the screen image district correspondence image of this position, according to the metrical information in the case history, setting-out marks the position of parameter measurement on image, shows the value of the parameter that will check in parameter display area.(8) if in system's main menu, select collection of illustrative plates demo function, system start-up collection of illustrative plates demonstration module.Can be divided into following several module:
Image acquisition module: after the fundus photograph of various types of ratio carried out collating sort, take in video camera, with the video signal digitization of Video Adapter, after cutting, change into the bitmap images of WINDOWS BMP (512 * 512 * 8) form then, deposit hard disk in video camera output.
Figure generation module: at first import the eye fundus image that to describe,, call the figure generating algorithm of respective classes, deposit hard disk in WINDOWS WMF reference format then then according to the needs of symptom demonstration.This is an independently module.
Image display: utilize Video Adapter to show the 256 color eye fundus images of storing with WINDOWS BMP form.
Explain orally the literal memory module: be used for the literal of symptom explanation and will deposit hard disk in WINDOWS DLL mode with getting in touch of Presentation Graphics.The benefit of this mode is the relative independentability of RETINAL IMAGES explanation of all categories.
Demonstrating required all images is optical fundus photochrome captured under the ophthalmoscope; A small amount of fluorescein angiographic (black and white) is also arranged, main in order to show trickleer pathological changes situation.Utilize picture that multimedia card will clap into the video recording form by the collection of PC Video interface, form the bitmap (BMP) of Windows256 color (8 of every pixels) behind the digitized, handle through cutting again, just made the standby image of certain specification.Remarkable advantage of the present invention: the optical fundus blood vessel picture check method that (1) system takes, be nondestructive inspection (NDI), human body is not had injury, can reflect small tremulous pulse or venous metamorphosis that hypertension causes, thereby the reflection blood pressure is to the influence degree of human body, for objective guidance treatment and medication.Owing to provide quantitative parameter and index, avoided the ambiguousness that only depends on the perusal diagnosis to bring in the past; (2) system interface is directly perceived, and is simple to operate; (3) gain quick return in investment, can extensively be generalized to hospitals at different levels at county level and above county level.
The drawing explanation: Fig. 1 is the system hardware structure connection diagram of the embodiment of the invention 1; Fig. 2 is the system hardware structure connection diagram of the embodiment of the invention 2; Fig. 3 is the systematic functional structrue sketch map.
Embodiment with reference to the description of drawings device: example 1:
As shown in Figure 1, optical fundus microscopic camera 1 connects gamma camera 2, and gamma camera 2 is connected with video multimedia card 3, and video multimedia card 3, network interface card/modem 6, streamer tape device 7 and laser printer 5 all are connected with 486 microcomputers 4.Example 2:
As shown in Figure 2, optical fundus microscopic camera 1 connects scanner 9, and scanner 9, video multimedia card 3, network interface card/modem 6, erasable optical disk driver 8 and laser printer 5 all are connected with 486 microcomputers 4.Fig. 3 represents that symbol is among the system functional block diagram figure: 1 obtains optical fundus retinograph 2 photos is digitized into exterior storage that digital image 3 digital image processing 4 parameter measurements analyze 5 system managements and network communication 8 case histories of single 7 case histories of control 6 printed report and recovers 9 case histories and inquire about 10 collection of illustrative plates and demonstrate the annexation of each function and be: as shown in Figure 3, obtain blood vessel picture at the bottom of the patient's eyes by function 10, under the control of system management and control function 14, by function 11 photo is digitized into digital image, carry out image processing by 12 pairs of digital images of function, image after the processing carries out the parameter measurement analysis by function 13, and the result is by function 15 printouts; Exist case history on the system disk under the control of function 14, can carry out network communication 16, externally on the memorizer storage with recover 17, can inquire about 18; Classical symptom can inquire about 19 as collection of illustrative plates separately.

Claims (2)

1, a kind of non-invasive quantitative diagnosis system of cardiovascular disease is characterized in that comprising with lower device:
An optical fundus microscopic camera (1) is arranged; A gamma camera connects (2) and connects video multimedia card (3) or scanner; The core component of system is microcomputer (4) (PC486 reaches with mo(u)ld top half), and video multimedia card (3) or scanner, magnetic tape controller (7) or erasable optical disk driver (8) and laser printer (5) all are connected with microcomputer (4).
2, the using method that is used for the harmless quantitative diagnosis system of cardiovascular disease is: take the optical fundus retinograph with the optical fundus microscopic camera, under system program control, photo is digitized into the computer digit image, and in computer, forms patient's multimedia case history framework by gamma camera, multimedia card (or scanner); In microcomputer, control as showing with multimedia card, patient's RETINAL IMAGES is presented on the computer screen, adopt people-machine interactive mode to select measured zone, this zone digit image is handled, the characteristic parameter of disease is measured and analyzed, by computer disease is carried out auxiliary diagnosis, and print result's report.Its characterization step is: (1) starts this computer working, the display system main menu, main menu is provided with four autonomous graphic buttons, and case history Measurement and analysis, collection of illustrative plates demonstration, system specialization are carried out in selection respectively according to custom menu, four feature operations log off; (2) if menu option is the case history Measurement and analysis, then start the case history measurement analysis program, comprise that four function of tonic chord items supply the user to select: a) patient's image acquisition; B) patient history analysis; C) patient history is checked; D) withdraw from (3) if user option is patient's image acquisition, then program requires to import patient's essential information in the dialog box mode: name, age, sex, used amplification visual angle when fundus photograph is taken, check a left side/right eye, when the user confirms that input is finished, the information of program read-in input is also carried out error checking, after checking that input is errorless, create patient's multimedia case history document framework, and write patient's essential information, start image acquisition then, promptly determine that by the user the current image that will gather is in the quadrant position on optical fundus (on the nasal side, under the nasal side, on the temporo side, under the temporo side, central authorities), and generate the filename of image with patient's essential information according to user's choice of location, with current photo digitized and be kept at visual relief area, select measured zone in the image with removable window by the user, only this measured zone image subsection is saved in the image file, and the image processing surveying marker of putting this position image in the case history is the measurement of being untreated, carry out the image acquisition of another position then, after the image acquisition of five positions is finished, confirm to withdraw from the image acquisition program by the user; (4) if user option is the patient history analysis, then start the patient history analytic function, select to have existed the patient name of multimedia case history to carry out analysis of medical record with the combination dialog box, according to patient name, open patient's multimedia case history file, read in patient's essential information, image acquisition information, handle metrical information, select to handle the position image of measurement by the user with the dialog box mode, with pack into the visual relief area of multimedia card of the image of pending measurement, carry out the image processing conversion according to the image processing pattern that the user selects, and the result is write visual relief area cover former image; (5) for the parameter measurement of handling the back image, transmit patient's multimedia case history structure with pointer in control module and each parameter measurement intermodule, after each parameter measurement, measuring position information, measurement result are write in the case history structure, which kind of parameter of current measurement is selected by the user, and the measuring operation step of every kind of parameter is as follows:
A) the artery and vein caliber compares parameter measurement
Movably producing a parallel lines cursor (‖) with software in the measurement window, this cursor can arbitrarily be moved on image with mouse control by the user, and can be according to the deflection of user with the input of rolling thick stick, spacing, rotation and the size of adjusting the parallel lines spacing arbitrarily on image, live the both sides outward flange of blood vessel with the light ticket holder, can read the diameter of blood vessel, parameter can be according to the customer requirements repeated measurement, five times at the most, get its meansigma methods as final measurement, another kind method adopts semi-automatic measuring, make parallel lines cursor and blood vessel center line parallel in the measurement window, and be slightly larger than blood vessel diameter, select to measure automatically button, system detects the edge of blood vessel automatically, calculates the caliber of tested blood vessel;
B) arterial bifurcation parameter measurement
In removable measurement window, produce one
Figure A9610797900041
Shape is measured cursor, and each branch of cursor all can change spacing and direction, when cursor and arteries branch coincident, can obtain each branched caliber of tremulous pulse, caliber ratio, branch angle;
C) the reflective parameter measurement of tremulous pulse axis
In removable measurement window, produce parallel lines and measure cursor (‖), make this cursor be parallel to the arteries centrage and greater than blood vessel diameter, after selecting to determine key, read vascular cross-section gray scale numerical value, calculate radially shade of gray of blood vessel, with the outward flange of the minimum and maximum value of gradient position as blood vessel, with the blood vessel inside gradient greatly and the minimum position as the edge of reflective tape in the blood vessel, calculate the blood vessel diameter of tremulous pulse, the width of axis reflective tape, the reflective width ratio of reflective tape width and blood vessel diameter, the intensity of light reflection of the maximum gray scale of reflective tape and vessel boundary gray scale compares etc.;
D) artery and vein impression parameter measurement
In measurement window movably, produce one intersect linear cursor ( ), overlap with the vein center line with the tremulous pulse that intersects respectively with two lines of this cursor, obtain the angle of the crossing and measuring position, the artery and vein relative position is judged in the dialogue of people's one machine, further does the artery and vein taper measurement, differentiates the impression degree according to above parameter result;
E) retinal hemorrhage area measurement
In measurement window movably, follow the tracks of at hemorrhage regional surrounding edge with mouse, and fill this hemorrhage zone, measure the area and the girth in hemorrhage zone, can measure ten zones simultaneously;
After finishing the parameter measurement of this position image, return and handle image selection dialog box, carry out the processing and the parameter measurement of next position image, or withdraw from the parameter measurement program;
F) finish in the customer analysis measurement, select to withdraw from operation, withdraw from this patient's analysis of medical record after, program promptly enters case history printing function state automatically, shows the function selecting of printer, the user begins to print the case history report after confirming that printer setup is correct.According to the information in the multimedia case history structure, print the System Reports list that contains patient's essential information, measures image, measurement result, measuring position and computer aided diagnosis results according to WINDOWS graphics device mode; (6) inquiry case history
If the user need inquire about case history, then in case history Measurement and analysis main menu, select the case history query option, program enters case history query function module, shows case history query function interface, selects patient, the position image that will check and the parameter that will check in combination controller chassis mode by the user.Behind user's setting check, open the multimedia case history file of given patient and with medical record information structure graftabl, in the multimedia card of screen image district correspondence image display buffer, pack into the image of this position, according to the metrical information in the case history, setting-out marks the position of parameter measurement on image, shows the value of the parameter that will check in the screen parameter viewing area; (7) collection of illustrative plates demonstration
When if the user selects the collection of illustrative plates demo function in system's main menu, system start-up collection of illustrative plates demonstration module then, comprise following submodule: the image acquisition module, the figure generation module, image display and explanation literal memory module, utilize gamma camera, multimedia card forms collection of illustrative plates picture digitized the bitmap (BMP) of Windows256 color, handle through cutting, made the standby image of certain specification, with the index of Image Name as image management, explanation literal with each trifle eye fundus image of optical fundus collection of illustrative plates, the Presentation Graphics file (utilizes the means of graphics, the file that various optical fundus characteristic information is demonstrated out with the form of animation), data blocks of composition such as dynamic demonstration comment are put into resource file and are generated dynamic link library, with the mode confession system call of DLL.Image is called in by the pathological changes classified catalogue, and each catalogue is all concentrated corresponding all images;
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