EP4387530A2 - Procédé de détection non invasive d'un développement d'un état dans le temps d'une structure tissulaire - Google Patents

Procédé de détection non invasive d'un développement d'un état dans le temps d'une structure tissulaire

Info

Publication number
EP4387530A2
EP4387530A2 EP22765458.9A EP22765458A EP4387530A2 EP 4387530 A2 EP4387530 A2 EP 4387530A2 EP 22765458 A EP22765458 A EP 22765458A EP 4387530 A2 EP4387530 A2 EP 4387530A2
Authority
EP
European Patent Office
Prior art keywords
data
image data
measurement
server
local terminal
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
EP22765458.9A
Other languages
German (de)
English (en)
Inventor
Ulrich Baumann
Vincent Boris BAUMANN
Peter Nuot FREI
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Compremium Ag
Original Assignee
Compremium Ag
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Compremium Ag filed Critical Compremium Ag
Publication of EP4387530A2 publication Critical patent/EP4387530A2/fr
Pending legal-status Critical Current

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Classifications

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Definitions

  • the invention relates to a method for the non-invasive detection of a temporal development of a state of a tissue structure.
  • the invention further relates to a system and a computer program for carrying out the method.
  • the compartment or compartments concerned should be monitored after a traumatic event.
  • a number of examinations are carried out at intervals of several hours.
  • the result of the respective examination as well as the development over time are used as the basis for a diagnosis and as a basis for the decision on surgical treatment.
  • Various techniques are known for the examination. The simplest is manual palpation to record the elastic properties of the compartment. The examining doctor relies primarily on his or her experience, so that different specialists can draw different conclusions. Higher reliability can be gained with pressure measurements directly in the compartment - however, these examinations are invasive and therefore painful and generally associated with the risk of infection.
  • a method for the non-invasive detection of a temporal development of a state of a tissue structure comprises the following steps: a. non-invasive recording of first measurement data of a body region to be examined and generation of first image data from the recorded measurement data; b. local pre-processing of the first image data using a first local terminal; c. Transmission of the pre-processed first image data and the first identification data from the first local terminal to a server for storage; i.e. at a later point in time retrieval of filed image data from the server with a second local terminal, using second identification data; e. displaying the retrieved image data on the second local terminal; f. non-invasive recording of second measurement data of the body region to generate second image data.
  • the method can be used in humans in particular, but can also be used in veterinary medicine.
  • Additional information can be obtained from the image data during pre-processing, e.g. B. intensity curves and/or histograms.
  • the image data can also be compressed, for example. Depending on the basis on which the first image data was obtained and the form in which it is available, more or fewer steps are necessary as part of the pre-processing.
  • the transmission of the pre-processed first image data and the first identification data from the first local terminal to the server can take place directly via a data network to which both the first local terminal and the server are connected, or there is a local connection with respect to the first local terminal Gateway used with which the first local terminal communicates and which takes over the data transmission to and from the server for all local terminals.
  • the data is transmitted in particular via a secure Internet connection (e.g. using Transport Layer Security - TLS).
  • the local end device is wirelessly connected to a router via a (again protected) WLAN connection, for example. It is also possible, for. B. a transmission over a mobile network. If a gateway is used, the data to be transmitted can be cached locally.
  • the later retrieval of the image data does not necessarily take place with the same end device and because a different gateway can also be used (e.g. when the patient is transferred to another department or hospital), the data should be sent within a maximum period of time further transmitted to the server so that it can be called up at a later point in time.
  • Local intermediate storage can also take place on the first local terminal itself, in particular if transmission to the gateway or to the server is temporarily not possible.
  • the data required for the second, later measurement (e.g. the first image data) from the local cache can be used - provided the same local end device is used again.
  • the pre-processed first image data or further processed image data obtained therefrom are linked to the first identification data after storage.
  • the first local terminal and the second local terminal can be two devices or the same device, e.g. B. depends on whether the patient is examined in the time-spaced examinations at the same place and / or by the same person.
  • the data storage on the server ensures that in both cases the second measurement data can be obtained precisely and reliably in the same way. The same applies to any other local terminals that are used to examine the patient over time.
  • the stored image data can be retrieved directly using this data. Is it different information, e.g. B. image data, the first identification data and the second identification data are usually not identical. In this case, a comparison operation takes place on the server in order to assign the first identification data to the second identification data.
  • the stored image data can be the preprocessed first image data previously transmitted by the first local terminal or image data further processed on the server on the basis thereof. In addition to the image data, other information linked to the first identification data can also be retrieved.
  • the display of the retrieved image data on the second local terminal device makes it easier to record the second measurement data, since the user - regardless of whether he carried out the first examination himself or not - can easily use this image data to ensure that he can carry out the second examination on same examination site and with the same examination parameters, e.g. B. in relation to the orientation of a section plane.
  • This image data can thus serve as a navigation aid in the second examination in order to ensure that the same tissue structure is examined and the same image section is generated.
  • further Information is stored on the server and retrieved from the second terminal that ensures the repeatability of the measurement, e.g. B. Distance information on the body surface, photos of the measuring point and/or a video sequence that documents the measuring process during the first examination.
  • the method is particularly advantageous for series of examinations that provide for the performance of several similar examinations of the same region of the body at time intervals of between a few minutes and a few hours.
  • the method is also particularly advantageous for examinations that are carried out using hand-held devices, because in these cases it can be particularly difficult to ensure the same basic conditions for several examinations at different times without the support of imaging.
  • the method according to the invention is not limited to carrying out two measurements; three or more measurements can be carried out in the same way, at a respective time interval, on the same, two or more local terminals.
  • This enables particularly precise monitoring of the recording of the second measurement data, in particular increased visual precision during the measurement process.
  • This increases the inter- and intra-observer reliability of the method. For example, the operator can immediately see whether the same tissue structure is being examined with essentially the same image section. Deviations in examination parameters can also be identified using the generated and displayed images in the easy to recognize the rule. Due to the real-time display, adjustments made by the operator have an immediate effect, resulting in intuitive and smooth operation.
  • the non-invasive recording of the first measurement data includes a sonographic measurement process.
  • CT X-ray examinations
  • MRI magnetic resonance imaging
  • OCT optical coherence tomography
  • the pre-processed first image data is advantageously displayed on the local terminal, and further first measurement data can be recorded based on the display.
  • the representation of the image data enables in particular a precise positioning of the corresponding measurement device.
  • the image data are particularly preferably displayed in quasi-real time, as is easily possible based on sonography, for example.
  • the pre-processing of the first image data can take place in the same way or in a different way for the display on the local terminal device and the transmission to the server. It is also possible to generate differently pre-processed image data and to transmit both to the server for storage. For example, first pre-processed image data can be retrieved later and displayed on the second local terminal device, while second pre-processed image data is stored on the server for reference or diagnostic purposes and is not required for recording second measurement data.
  • the non-invasive recording of the first measurement data can in particular include a measurement of a contact pressure.
  • the values of the pressing force are the other first measurement data mentioned. With the help of the contact pressure z. B. is applied essentially perpendicularly to the body surface, in particular elastic properties of the examined tissue structure can be determined.
  • Other measurement data can also be obtained and linked to the first measurement data that was used to obtain the image data. This includes, for example, information about heartbeat, blood pressure, blood oxygen saturation, body temperature, etc., possibly related to the location of the respective examination.
  • dimensions can be determined both in the first image data and in the second image data with at least two different contact forces in each case.
  • the dimensions can be point positions, lengths, areas or volumes. Also possible are ratios, e.g. B. corresponding to the eccentricity of an elliptical surface or a length ratio of two parallel lines or lines at a certain angle.
  • tissue structure By comparing the dimensions as they result from different contact forces, a direct measure of the elasticity (or rigidity) of the tissue structure examined can be obtained.
  • strong compression of a tissue structure achieved as a result of the action of force means that it has high overall elasticity, while low compression indicates low elasticity (or high rigidity).
  • a low level of elasticity can indicate a high internal pressure in these compartments in particular.
  • a compartment is understood here as a closed cavity or receiving space inside the body, in which there is a certain pressure that can fundamentally differ from the pressure in the surrounding tissue.
  • compartments that can be elastically deformed by an external force are. Such compartments include in particular the compartments of muscle tissue, blood vessels and organs (e.g. the liver or the brain).
  • a manual marking process can be carried out on the first image data and second image data presented.
  • an operator defines one or more points, lines, areas and/or volumes in the displayed image data, in particular via a user interface of the first local terminal and/or the second local terminal. This results in length, area or volume values or other geometric variables, such as e.g. B. angles or eccentricities.
  • a representation of an intensity profile of the first or second image data is advantageously displayed along a line.
  • the proposal is generated in particular with the help of common image processing methods, e.g. B. to detect edges.
  • common image processing methods e.g. B. to detect edges.
  • it can also be based on a (monitored) machine learning process, e.g. B. with the help of an artificial neural network, with previously made markings of the same or other Operators and the corresponding image data serve as training data for training and improving the model.
  • the dimensions can also be determined automatically on the basis of the first image data or second image data.
  • the determination of the dimensions can—like the generation of the proposal—in particular be based on common image processing methods and/or a machine learning process. It is also possible to initially provide a manual marking process in an overall system for carrying out the method according to the invention and only allow the automatic determination for a specific measurement process if the adjustments made by the operators to automatically generated suggestions statistically fall below a predetermined level.
  • the location of the measurement to be taken can be determined by the operator, e.g. B. by a corresponding marking process on the image data, but it can also be determined automatically.
  • the location is specified by the operator for the first measurement; for the subsequent measurements, it is then automatically determined using the image information, e.g. B. by bringing the most recent image data into agreement with the first image data using a matching method and transferring the location of the measurement from the first image data to the most recent image data.
  • the measurement and any subsequent steps can thus be carried out fully automatically as soon as the corresponding measurement data can be recorded, e.g. B. as soon as a measuring head of a measuring unit is positioned appropriately.
  • This positioning can be supported by the system, e.g. B. by displaying the measuring location for the measuring head with the help of a projected marking on the body surface or with the help of augmented reality techniques.
  • a first value for the elastic state of the fabric structure based on the first measurement data and based on the second measurement data is derived from the determined dimensions for the different contact pressures second value for the elastic state of the fabric structure is determined, with the first value and the second value representing a measure of the deformability of the fabric structure.
  • the values for the elastic state of the tissue structure can be values that are a measure of the elasticity of the examined tissue or values that are a measure of the rigidity of the examined tissue.
  • an ultrasonic measuring head with an integrated pressure measuring device, as z.
  • an image of the tissue structure to be examined is generated and displayed at the same time and the contact pressure exerted, corresponding to a specific contact pressure, is measured. Once the required pressure is generated, the dimensions can be determined using the image. In the case of manual marking, this can be supported in that, when a predetermined pressure value is reached, a still image of the current ultrasound image is immediately generated and displayed for the subsequent marking process. With an automatic determination of the dimensions, the image at the corresponding pressure value can be used as a basis.
  • the creation of a still image or the automatic evaluation can be repeated for several specified pressure values.
  • the operator only has to place the measuring head at the point corresponding to the tissue structure to be examined, slowly increasing the contact pressure, e.g. B. for a few seconds, manually increase and then decrease again.
  • the still images generated at the specified pressure values are then displayed and the dimensions can be determined.
  • CP score A possible definition of a value for the elastic state of the tissue structure is the so-called "CP score", defined as follows:
  • a CP score of 0% corresponds to (theoretical) complete compression along the line mentioned, i.e. high elasticity (or low stiffness).
  • a CP score of 100% corresponds to a lack of compression along the line mentioned, i.e. low (or no) elasticity (or maximum stiffness).
  • the CP scores at different points in time represent valuable basic information for the diagnosis of the compartment syndrome. Their absolute value can be compared with threshold values and/or the course over time, in particular the time gradient of the CP score, is considered in order to make statements. Due to the definition as a ratio, systematic errors can be eliminated from the outset.
  • Modified CP scores are possible to characterize other tissue structures, in which the determination of the dimensions e.g. B. takes place at other predetermined pressure values. Likewise, the measure can be generalized to account for measurements at more than two pressure values.
  • Time information is preferably transmitted to the server for storage with the preprocessed first image data and the first identification data.
  • the time information is linked to the image data and the identification data on the server.
  • further data can be transmitted to the server for storage, e.g. B. Measurement parameters or identification data relating to the person performing the measurement.
  • a medically relevant point in time in particular a point in time of a traumatic effect, is advantageously recorded and transmitted to the server for storage.
  • traumatic event e.g. B. an acute compartment syndrome
  • time of the traumatic impact is known and included in the diagnostic assessment. The time of the traumatic impact therefore represents important further basic information for a subsequent diagnosis.
  • measurement data are already available, these can be compared with the typical curves, taking into account the recorded time of the traumatic impact. For example, a corresponding improved measure for characterizing the state of the tissue structure can be generated from this comparison.
  • the traumatic effect can enable a more reliable or earlier detection of a development leading to the acute compartment syndrome or a harmless course.
  • the first point in time at which pain occurs during sporting activity can only be used for the purpose of analysis or equated to traumatic exposure in standard investigation protocols.
  • a recommendation for a point in time for recording the second measurement data can also be generated.
  • the body region to be examined is preferably provided with an individual marking. This marking is read by a first reading device, and the first identification data are generated using the marking read. Before retrieving the filed image data, the marking is read again with a second reading device, and the second identification data is generated using the marking that has been read.
  • the marking ensures the correct assignment of several measurement data recorded at different times to the same patient or to the same body region. It can generally be the body region to be examined, e.g. B. denote a limb. In this case, the subsequent examination is based on further information, e.g. B. physiological information. However, the marking can also be placed directly at the location of the examination to be carried out, so that the location to be examined is marked directly.
  • the marking can be universally unique, e.g. B. by including a centrally assigned, unique identification number. However, statistical unambiguousness is sufficient so that individual patients or body parts to be examined can be distinguished at a treatment location (e.g. a hospital) with a probability bordering on certainty, if necessary also with recourse to further information.
  • the identification information e.g. B. a number or an alphanumeric character string, corresponds in particular to the content or part of the content of the mark.
  • it can also be image data, for example.
  • the first reading device and the second reading device can be two devices or the same device, e.g. B. depends on whether the patient is examined in the time-spaced examinations at the same place and / or by the same person.
  • a specific patient can be examined several times with the same devices or with different devices, without the operators having to make an assignment manually.
  • a tag with a clear identification is preferably attached to the body region, in particular glued on.
  • the tag can include optically readable information (e.g. a barcode or dot-matrix code) and/or electrically readable information (e.g. using RFID technology).
  • optically readable information e.g. a barcode or dot-matrix code
  • electrically readable information e.g. using RFID technology
  • the first reading device and the second reading device are preferably optical reading devices, in particular cameras.
  • the reading device can be integrated into a measuring head for recording the first or second measurement data, e.g. B. an ultrasound head, be integrated. However, it can also go into the first or local end device can be integrated, or they are stand-alone devices. Instead of cameras, dedicated reading devices can be used to capture standardized codes, e.g. B. barcodes or dot matrix codes can be used.
  • the first reading device and the second reading device comprise transponders for cooperating with RFID transponders in a corresponding tag.
  • the reading devices can be integrated particularly easily into the measuring heads.
  • the reading device can also be a keyboard or a touch screen. If the individual marking includes information such as numbers or strings of characters that can be optically detected directly, in particular in addition to machine-readable information, this can be read and typed in by an operator. However, the presence of machine-readable information is an advantage, because in particular the risk of error processing can be minimized.
  • the identification data can also be obtained using other information or documents, e.g. B. by reading or typing information on a bracelet, on a label attached to another part of the body or on a patient file or chart.
  • a system for carrying out the method according to the invention comprises: a. a measuring device for the non-invasive recording of measurement data of a body region to be examined in a measurement process; b. at least one local terminal with a display device; and c. a server for storing and forwarding received data; wherein the at least one local terminal and the server are set up for the mutual exchange of data; the at least one local terminal is set up to receive measurement data from the measurement device and to generate and display image data from the received measurement data; the at least one local terminal is set up to transmit identification data and the image data to the server; and the at least one local terminal is set up to retrieve stored image data from the server using identification data transmitted to the server and to display this retrieved image data during a measurement process.
  • each of the devices is capable of generating first measurement data and second measurement data as required. It is preferably recognized automatically, based on the identification data, whether image data that have already been stored are present and whether they are to be retrieved and displayed. For this purpose, for example, the identification data is always transmitted to the server, which then returns either the stored image data and/or information about the presence of previous measurements or image data.
  • a preferred embodiment of the system according to the invention further comprises at least one reading device for reading an individual marking on the body region to be examined and for generating corresponding marking data, the at least one local terminal being set up to receive the marking data from the reading device and to generate the identification data from this marking data is.
  • the same reading device can always be used over time, or different devices can be used.
  • a computer program which is suitable for controlling a local terminal of the system according to the invention, comprises instructions which, when the program is executed by a computer, cause it to carry out the following steps: a. receiving first measurement data from a measurement device and generating and displaying first image data from the received first measurement data on a display device; b. transmitting identification data and the first image data to a server; c. transmitting second identification data to the server; i.e. Receiving stored image data from the server based on the transmitted second identification data; e. displaying the received image data on the display device; f. receiving second measurement data from the measurement device and generating and displaying second image data from the received second measurement data on the display device.
  • the computer program also includes commands to carry out the following steps:
  • FIG. 1 shows a schematic illustration for explaining an embodiment of the system according to the invention
  • FIG. 2 shows a schematic representation of the data exchange when carrying out the method according to the invention
  • 3-18 depictions of the user interface of the terminal of the system according to the invention when the method according to the invention is being carried out.
  • FIG. 1 is a schematic illustration for explaining an embodiment of the system according to the invention.
  • the system includes a server 10.
  • This is a common computer system that is suitable for server operation. It includes, among other things, a central processing unit 12 and a database 14 and a communication interface 16 which are connected to the central processing unit 12 .
  • the computer system is connected to a data network, in particular the Internet, and protected against improper access locally and from outside using standard measures.
  • the database 14 or the storage of the corresponding data can be implemented locally on the server 10 or in a cloud.
  • the server 10 communicates with several local terminals 100.1, 100.2. These are designed in particular as tablets and include, among other things, a communication interface 102.1, 102.2, a touch screen 104.1, 104.2 and a camera 106.1, 106.2.
  • the communication with the server 10 takes place via the communication interface 102.1, 102.2 via a secure (e.g. with TLS) Internet connection.
  • a secure e.g. with TLS
  • validated certificates in particular are used.
  • the connection between the local terminals 100.1, 100.2 and the server 10 can be direct, or a gateway server is arranged in the vicinity of the local terminal 100.1, 100.2, with which the local terminal communicates. This in turn then communicates with the server 10.
  • the local terminal device 100.1, 100.2 is in particular wirelessly connected to the data network or the gateway server, in particular via WLAN, a cellular connection or Bluetooth.
  • the system also includes measuring heads 1 10.1, 1 10.2. These are connected via a cable 1 12.1, 1 12.2 to a respective local terminal 100.1, 100.2.
  • the measuring head 1 10.1, 1 10.2 is supplied with electrical energy via the cable 1 12.1, 1 12.2, and data is also exchanged with the local terminal device 100.1, 100.2 via this cable.
  • the measuring head includes a local energy store, in particular a chargeable battery, and the data communication with the local terminal device takes place wirelessly, for example via a Bluetooth connection.
  • Each of the measuring heads 1 10.1, 1 10.2 includes in the illustrated embodiment, an ultrasonic measuring unit and a pressure measuring unit, such as. B. described in EP 3 716 842 A1 (Veinpress GmbH), i. H. ultrasound data can be generated for imaging and the contact pressure between the measuring head 110.1, 110.2 on the body surface can be determined and output at the same time as the ultrasound data are being recorded.
  • the ultrasonic frequency is about 10 MHz, resulting in a resolution of about 0.07 mm.
  • the required penetration depth is 5-10 cm.
  • the contact pressure is determined by measuring the force, e.g. B. using a (MEMS) strain gauge, a capacitive measuring cell or a piezo measuring cell.
  • the measuring range is 0 - 100 mmHg, for example. A measurement accuracy of 2-5% from a minimum pressure of 5 mmHg is required.
  • the corresponding measurement data are transmitted from the measuring head 1 10.1, 1 10.2 in real time and synchronized with one another to the respective local terminal 100.1, 100.2.
  • the measurement data is transmitted (and displayed) at a frequency of 20 frames/s or more, so that the operators have a continuous display.
  • GUI user interface
  • Self-adhesive tags 120 are used in the system according to the invention. They include a dot matrix code, e.g. B. a QR code and can be stuck to the skin surface in this area to mark a body region.
  • the adhesive used is chosen so that the tags 120 remain on the skin surface for several hours to days. At the same time, skin irritations are avoided as far as possible and the tags 120 can be removed essentially painlessly as soon as they are no longer needed.
  • Multiple tags 120 with the same code are provided for each body region. As mentioned, one of the tags 120 is glued onto the body region, and another can be glued into a patient file, for example.
  • the present exemplary embodiment is explained using an application in which the front compartment in the left lower leg 1 of a patient is to be examined with regard to a possible compartment syndrome (log syndrome).
  • FIG. 2 is a schematic representation of the data exchange when carrying out the method according to the invention. Shown are the most important data inputs and transmissions between the measuring head 110, the local terminal 100, a local gateway 20 and the server 10 along a time axis 30, beginning with a traumatic effect (time 31).
  • the local gateway 20 is used here only for Forwarding data received from the server 10 to the local terminal 100 (which can be one of several local terminals) or vice versa for forwarding data received from the local terminal 100 to the server 10.
  • the gateway Function is therefore not further mentioned in the following.
  • the system can be implemented without a gateway 20; in this case, the communication takes place directly between the local terminal 100 and the server 10.
  • the recorded data are first buffered on the local terminal device 100 . As soon as there is a connection to the server 10, they are stored on the server (or the corresponding cloud service). The data is automatically deleted on the local end device 100, usually 2 weeks after the last access. In exceptional cases, when the local storage is no longer sufficient, the data will be deleted before this period of time, starting with the oldest. If necessary, the data is retrieved from the server.
  • the data is also stored in the database or cloud for a specified - longer - period of time unless it is deleted manually at the request of an authorized person.
  • the data stored in the database or in the cloud includes the following information for each measurement carried out:
  • Position of the local end device used (via GPS or IP address);
  • Result values e.g. CP score, see below.
  • FIGS. 3-18 are representations of the user interface of the terminal of the system according to the invention when the method according to the invention is being carried out. It should be noted that not all steps are illustrated, only the most important ones.
  • the user interface is displayed on the touchscreen 104.1, 104.2 of the local terminal 100.1, 100.2. This is also used for user inputs, which can take place in a manner known per se through the interaction of one or more fingers of the user and/or a stylus with the surface of the touchscreen 104.1, 104.2.
  • Other input means e.g. B. keys can be provided.
  • the touchscreen can be set up to record pressure-dependent inputs and/or to provide haptic feedback.
  • the user guidance is supported by colors, but the user interface is shown in shades of gray in Figures 3-17.
  • a tag 120 is stuck onto the body region to be examined, here on the lower leg below the knee (time 32). With the help of the camera of the local terminal 100, the attached tag is now recorded (FIG. 3), and the local terminal 100 decodes the corresponding dot matrix code to obtain a unique identification character chain (ID string).
  • the local terminal 100 transmits this ID string (data 201.1, 201.2) to the server 10 to check whether there are already data linked to this ID string. If this is the case, the data 202.2 is transmitted from the server to the local terminal. Otherwise there is a response (data 202.1) that no data is available yet, and a new local data record is created on the local terminal, to which the ID string is assigned. In the following it is assumed that no data was yet available on the server 10, ie an initial measurement is being carried out.
  • the ID string 151 is now displayed.
  • the operator is prompted to provide information about the body region to be examined.
  • she selects the extremity to be examined from a schematic body diagram 152 (here the left leg).
  • the compartments of this extremity that can be examined are then displayed in a selection list 153, and the operator selects the corresponding compartment here (here the front compartment in the lower leg).
  • the operator can start the measurement (time 33). This is done with the help of the measuring head 110, the image data and print data generated by the measuring head 110 being transmitted in real time to the local terminal 100 (data 203.1, 203.2).
  • the local terminal 100 now checks whether a measuring head 110 is correctly coupled to it.
  • a request is issued to connect a measuring head or to check it.
  • the operator is asked to place it on the part of the body to be examined.
  • the ultrasound image 155 is presented in the user interface ( Figure 5).
  • the ultrasound image 155 is the usual two-dimensional B-scan.
  • the operator also has the option of setting the penetration depth and thus also the depth of the displayed image (Depth) using a controller 156 and the overall amplification (Gain) using a further controller 157 .
  • the operator is now also prompted to reduce the contact pressure to below 10 mmHg in order to start the actual measurement process.
  • the contact pressure is shown on a scale 158 running from top to bottom on the right-hand edge of the image.
  • a central line 159 along the main detection direction of the ultrasound measuring head and a depth scale 160 on the left edge of the image are shown in the ultrasound image 155 .
  • the operator thus locates the point to be examined and then reduces the contact pressure. As soon as the contact pressure has been reduced below 10 mmHg, which is shown in FIG. 6, the measurement begins. The operator now gradually increases the contact pressure, with the increase taking place within a time frame of approx. 1-3 s. As soon as the pressure corresponds to 10 mmHg, a first recording is automatically saved and displayed in a corresponding image window 161 on the left side of the user interface (Fig. 7). The operator increases the contact pressure further. As soon as the pressure corresponds to 80 mmHg, a second recording is automatically saved and displayed in a further image window 162 below the first image window 161 (FIG. 8). The measurement process is now complete, which is confirmed to the operator in the user interface.
  • the values of the lower contact pressure and the upper contact pressure can be changed manually via the local device if required. It is also possible in the system for different compartments to specify different value combinations in order to capture the elastic properties in the best possible way.
  • a left-hand image window 163 shows the recording at a contact pressure of 10 mmHg
  • a right-hand image window 164 shows the recording at a contact pressure of 80 mmHg.
  • the user can now select one of the image windows 163, 164 for marking a distance by actuating a corresponding button 165, 166 ("Set distance") (FIG. 9).
  • a line 170 along the central line 159 is provided with two crosshairs 171, 172. These can be moved up (towards the body surface) or down (away from the body surface) along the central line 159 via the touchscreen until their location corresponds to the boundary of the compartment to be examined.
  • the distance between the two crosshairs 171, 172 is shown in a display area 173, here 26.1 mm.
  • the same process is repeated for the second shot in the right image window 164 . There, for the situation with a contact pressure of 80 mmHg, there is still a distance of 22.1 mm (cf. FIG. 11).
  • the crosshairs are positioned with pixel accuracy, which means an accuracy of approx. 0.1 mm, corresponding to i. W. the resolution of the ultrasound image.
  • the positioning can be supported by additional displays and/or operating elements, in particular by a line shape that represents the suitably averaged image brightness along the central line 159 and or buttons with which the crosshair position can be shifted up or down one pixel at a time .
  • a zoom function can also be useful, with which the area in the area of a crosshair can be displayed enlarged.
  • first selection element 178 type of traumatic injury (open wound, bruise, fracture); second selection element 179: result of a palpation (soft, elastic, firm); third choice item 180: general state of health (scale from 1-10);
  • button 181 indication that the patient is unresponsive; fourth optional element 182: information on medication.
  • the operator has the option of saving the recorded information (button 183) or skipping this step entirely ("Skip") (button 184).
  • the measurement is now shown in an overview according to FIG.
  • the value 175 for the CP score is represented by a data point in a line chart 185, supplemented by a date and time 186. Further information on the anamnesis can also be found in this representation.
  • the operator has the option of linking a new tag to the measurement (or the series of measurements) (button 187), exporting the data (button 188) or taking another measurement (button 189).
  • the user interface for linking a new tag is shown in FIG.
  • the earlier tag can be recorded by scanning this tag (e.g. in the patient file) or by entering the corresponding tag number.
  • the complete data 204.1, 204.2 of the measurement as listed above are transmitted to the server 10 after they have been completed.
  • FIG. 17 Several data points in the line graph 185 represent the CP scores of several measurements M1-M5. They are connected by a line, and the measurements (with the exception of the first) are supplemented by trend information 190, which results from a comparison of the respective measurement with the previous measurement. A possible deterioration in the condition of the compartment, corresponding to an increase in the CP score, is highlighted by a filled-in arrow. The course of the CP score can thus be intuitively recorded at a glance.
  • the web interface allows various operations related to the stored data, in particular:
  • Access to the server can be recorded in an electronic logbook.
  • the corresponding entries can e.g. B. contain the user, the device, the time and / or the data set considered.
  • the logbook can be stored on the server. Based on the logbook z. B. statistics are created or case-specific clarifications are carried out.
  • the invention is not limited to the illustrated embodiment. In this way, additional data can be recorded and processed, e.g. B. Data at the time of a traumatic impact or other information on the anamnesis or photo or video data to document the examination process.
  • the tag can be recorded with a reading device or camera arranged in the measuring head instead of with the camera of the local terminal device.
  • Specific properties and operating parameters of the components of the measuring head can be chosen differently depending on the application.
  • the repeated identification of the patient can take place in other ways, e.g. B. using another machine-readable or non-machine-readable data carrier, which is arranged in the area of the body region to be examined or outside of this body region on the patient or is provided independently of this.
  • the invention provides a method for the non-invasive detection of a development over time of a state of a tissue structure, which method provides improved basic information for diagnostic purposes based on a plurality of examinations staggered in time.

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Abstract

L'invention concerne un procédé de détection non invasive d'un développement d'un état dans le temps d'une structure tissulaire, au cours duquel des premières données de mesure de la région du corps (1) sont enregistrées de manière non invasive et des premières données d'image sont générées à partir des données de mesure enregistrées. Ces premières données d'image sont prétraitées localement à l'aide d'un premier terminal (100.1) local et sont transmises conjointement avec des premières données d'identification du premier terminal (100.1) local à un serveur (10) à des fins de stockage. Ultérieurement, les données d'image stockées au moyen de deuxièmes données d'identification sont extraites par le serveur (10) et affichées sur le deuxième terminal (100.2) local. Il s'ensuit un enregistrement non invasif de deuxièmes données de mesure de la région du corps (1) pour générer des deuxièmes données d'image.
EP22765458.9A 2021-08-17 2022-08-11 Procédé de détection non invasive d'un développement d'un état dans le temps d'une structure tissulaire Pending EP4387530A2 (fr)

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CH70175/21A CH718927A2 (de) 2021-08-17 2021-08-17 Verfahren System und Computerprogramm zur nichtinvasiven Erfassung einer zeitlichen Entwicklung eines Zustands einer Gewebestruktur sowie Verwendung des Verfahrens zur Gewinnung von Informationen zum elastischen Zustand von Kompartimenten.
PCT/EP2022/072593 WO2023020941A2 (fr) 2021-08-17 2022-08-11 Procédé de détection non invasive d'un développement d'un état dans le temps d'une structure tissulaire

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KR20240043793A (ko) 2024-04-03
CH718927A2 (de) 2023-02-28
WO2023020941A2 (fr) 2023-02-23
CN118076298A (zh) 2024-05-24

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