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Publication numberCN101237817 A
Publication typeApplication
Application numberCN 200580048789
PCT numberPCT/US2005/046919
Publication date6 Aug 2008
Filing date28 Dec 2005
Priority date28 Dec 2004
Also published asCA2592691A1, CA2592691C, CN101237817B, CN102973247A, CN102973247B, EP1835845A2, EP1835845A4, EP2319406A1, US9078619, US20070024946, WO2006086085A2, WO2006086085A3
Publication number200580048789.7, CN 101237817 A, CN 101237817A, CN 200580048789, CN-A-101237817, CN101237817 A, CN101237817A, CN200580048789, CN200580048789.7, PCT/2005/46919, PCT/US/2005/046919, PCT/US/2005/46919, PCT/US/5/046919, PCT/US/5/46919, PCT/US2005/046919, PCT/US2005/46919, PCT/US2005046919, PCT/US200546919, PCT/US5/046919, PCT/US5/46919, PCT/US5046919, PCT/US546919
Inventors亚历山大A帕纳俞克, 布莱恩H特蕾西, 斯韦拉纳V帕纳俞克, 珍妮E弗里曼, 迈克尔J霍普米尔
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External Links: SIPO, Espacenet
Hyperspectral/multispectral imaging in determination, assessment and monitoring of systemic physiology and shock
CN 101237817 A
The present invention provides a hyperspectral imaging system which demonstrates changes in tissue oxygen delivery, extraction and saturation during shock and resuscitation including an imaging apparatus for performing real-time or near realtime assessment and monitoring of shock, including hemorrhagic, hypovolemic, cardiogenic, neurogenic, septic or burn shock. The information provided by the hyperspectral measurement can deliver physiologic measurements that support early detection of shock and also provide information about likely outcomes.
Claims(68)  translated from Chinese
1. 一种用于获取休克数据的设备,其用于超光谱或者多光谱成像,所述设备包括如下部件至少之一: 检测器; 滤波器或者不带滤波器的波长检测器; 功率源;和图像获取硬件。 1. A data acquisition device shock, which is used hyperspectral or multispectral imaging, said device comprising at least one of the following components: a detector; a filter or wavelength detector without a filter; a power source; and image acquisition hardware.
2. 根据权利要求1所述的设备,其中,所述检测器是具有电荷耦合器件元件和透镜的数字摄像机。 2. The apparatus according to claim 1, wherein said detector is a charge-coupled device having a digital camera and the lens element.
3. 根据权利要求1所述的设备,其中所述滤波器是可见波长液晶可调谐滤波器。 3. The apparatus according to claim 1, wherein the filter is a visible wavelength of the liquid crystal tunable filter.
4. 根据权利要求l所述的设备,其中所述滤波器是NIR波长液晶可调谐滤波器。 4. The apparatus according to claim l, wherein said filter is a liquid crystal tunable filter NIR wavelengths.
5. 根据权利要求1所述的设备,其中所述滤波器具有对可见光和NIR 光两者进行滤波的能力。 5. The apparatus according to claim 1, wherein the filter has the ability to both visible and NIR light filtering.
6. 根据权利要求1所述的设备,其中使用具有两个滤波器的双系统, 所述滤波器是可见波长液晶可调谐滤波器和NIR波长液晶可调谐滤波器。 6. The apparatus according to claim 1, wherein the dual system has two filters, the filter is a visible wavelength tunable filter and the liquid crystal of the liquid crystal tunable filter NIR wavelengths.
7. 根据权利要求1所述的设备,其中使用具有可见波长液晶可调谐滤波器和窄带IR照明源的双系统。 7. The apparatus of claim 1, wherein the liquid crystal having a visible wavelength tunable filter and a narrow-band IR illumination source dual system.
8. 根据权利要求1所述的设备,其中使用具有可见波长液晶可调谐滤波器和一个或多个红外滤波器的双系统。 8. The apparatus according to claim 1, wherein the liquid crystal having a visible wavelength tunable filter and an infrared filter one or more of the dual system.
9. 根据权利要求1所述的设备,其中所述检测器是具有CMOS元件和透镜的数字摄像机。 9. The apparatus according to claim 1, wherein said detector is a digital camera having a CMOS element and a lens.
10. 根据权利要求1所述的设备,其中所述滤波器是声光可调谐滤波器。 10. The apparatus according to claim 1, wherein the filter is acousto-optic tunable filter.
11. 根据权利要求1所述的设备,其中所述滤波器是可开关滤波器阵列。 11. The apparatus according to claim 1, wherein said filter is a switchable filter array.
12. 根据权利要求1所述的设备,其中从一个或多个光源将一个或多个选定波长的光传输到所述滤波器中。 12. The apparatus according to claim 1, wherein the one or more light sources from the one or more selected wavelengths of light transmitted into the filter.
13. 根据权利要求1所述的设备,其中光的所述选定波长是NIR波长。 13. The apparatus according to claim 1, wherein said light is selected wavelength NIR wavelengths.
14. 根据权利要求1所述的设备,其中光的所述选定波长是可见波长。 14. The apparatus according to claim 1, wherein the selected wavelength is visible light wavelength.
15. 根据权利要求1所述的设备,其中光的所述选定波长是可见和NIR波长。 15. The apparatus according to claim 1, wherein the selected wavelength is visible light and NIR wavelengths.
16. 根据权利要求1所述的设备,其中所述滤波器被装配到所述摄像机透镜的前方。 16. The apparatus according to claim 1, wherein the filter is fitted to the front of the camera lens.
17. 根据权利要求1所述的设备,其中所述功率源对供应同轴或者接近同轴的照明的照明器提供功率。 17. The apparatus according to claim 1, wherein said power supply source to the coaxial or nearly coaxial illuminator provides illumination power.
18. 根据权利要求1所述的设备,其中使用软件程序来控制所述图像获取硬件。 18. The apparatus according to claim 1, wherein the software program used to control the image acquisition hardware.
19. 根据权利要求1所述的设备,其中所述设备是便携式的。 19. The apparatus according to claim 1, wherein said apparatus is portable.
20. 根据权利要求1所述的设备,其中实时地或者接近实时地进行数据的获取。 20. The apparatus according to claim 1, wherein the real-time or near real-time data is acquired.
21. —种用于从病人获取超光谱/多光谱数据的方法,包括: 照明所述病人的组织上的目标区域; 用透镜和检测器收集所述目标区域的数据图像; 执行标准数据分析和标准分类方法;以及确定全身生理状态。 21. - kind of used to obtain hyperspectral / multispectral data from a patient, comprising: a target area on the patient's tissue illuminating the; collecting the target area with the lens and the image sensor data; data analysis and implementation of standards Standard classification; and determining the physiological state of the body.
22. 根据权利要求21所述的方法,其中所确定的全身生理状态是休克或者与休克相关。 22. The method according to claim 21, wherein the determined physiological state body is associated with shock or shock.
23. 根据权利要求21所述的方法,其中所确定的全身生理状态与心脏代偿失调相关。 23. The method according to claim 21, wherein the determined general physiological state associated with cardiac decompensation.
24. 根据权利要求21所述的方法,其中所确定的全身生理状态与呼吸功能不全相关。 24. The method according to claim 21, wherein the determined general physiological state associated with respiratory insufficiency.
25. 根据权利要求21所述的方法,其中所确定的全身生理状态是血容量过低。 25. The method according to claim 21, wherein the determined physiological state of the body is hypovolemia.
26. 根据权利要求21所述的方法,其中所确定的全身生理状态与糖尿病的进展相关。 26. The method according to claim 21, wherein the determined general physiological state associated with the progression of diabetes.
27. 根据权利要求21所述的方法,其中所确定的全身生理状态与充血性心力衰竭相关。 27. The method of claim 21, wherein the determined physiological state of the body associated with congestive heart failure.
28. 根据权利要求21所述的方法,其中所确定的全身生理状态是感染或者败血症。 28. The method according to claim 21, wherein the determined physiological state systemic infection or sepsis.
29. 根据权利要求21所述的方法,其中所确定的全身生理状态是脱水。 29. The method according to claim 21, wherein the determined physiological state of the body is dehydrated.
30. 根据权利要求21所述的方法,其中所确定的全身生理状态是出血o 30. The method according to claim 21, wherein the determined physiological state is systemic bleeding o
31. 根据权利要求21所述的方法,其中所确定的全身生理状态是血压过低。 31. The method according to claim 21, wherein the determined physiological state is systemic hypotension.
32. 根据权利要求21所述的方法,其中所确定的全身生理状态是高血压。 32. The method according to claim 21, wherein the determined physiological state is systemic hypertension.
33. 根据权利要求21所述的方法,其中所确定的全身生理状态是受到化学或者生物剂的作用。 33. The method according to claim 21, wherein the physiological state of the body is determined by the effect of chemical or biological agents.
34. 根据权利要求21所述的方法,其中所确定的全身生理状态是炎症反应。 34. The method according to claim 21, wherein the determined physiological condition is systemic inflammatory response.
35. 根据权利要求21所述的方法,其中所确定的全身生理状态与全身、区域或者局部施加的药物或者施予的其它治疗相关。 35. The method according to claim 21, wherein the medicament determining the physiological state of the body and systemic, regional or local administration imposed or other therapeutic relevance.
36. 根据权利要求21所述的方法,其中标准数据分析包括将所述数据图像转换为光学密度单位。 36. The method according to claim 21, wherein the standard data analysis includes converting the data images to optical density units.
37. 根据权利要求21所述的方法,其中标准分类方法包括对于超立方体中的每一个光谱计算脱氧血红素系数测量值。 37. The method of claim 21, wherein the standard classification methods include the hypercube each calculated spectra measured deoxyhemoglobin coefficients.
38. 根据权利要求21所述的方法,其中标准分类方法包括对于超立方体中的每一个光谱计算氧合血红素系数测量值。 38. The method of claim 21, wherein the standard classification approaches include the hypercube each calculated spectra oxyhemoglobin coefficient measurements.
39. 根据权利要求21所述的方法,其中标准分类方法包括对于超立方体中的每一个光谱计算氧饱和度百分比。 39. The method of claim 21, wherein the method comprises the classification criteria for each of the hypercube spectrum percentage oxygen saturation calculation.
40. 根据权利要求21所述的方法,其中标准分类方法包括对于数据或者主分量的区别分析。 40. The method of claim 21, wherein the method comprises the classification criteria for data analysis or a principal component of the difference.
41. 根据权利要求21所述的方法,其中所述组织是前臂皮肤、前额皮肤、颊皮肤、口腔黏膜或者直肠黏膜。 41. The method according to claim 21, wherein said tissue is the skin of the forearm, forehead skin, cheek skin, oral mucosa or rectal mucosa.
42. —种用于从病人获取超光谱数据的方法,包括: 照明所述病人的组织上的目标区域; 用透镜和检测器收集所述目标区域的数据图像; 利用算法将所述数据图像转化为光学密度单位; 生成所述数据图像的超立方体;对于所述超立方体中的每一个光谱计算氧饱和度百分比;以及确定休克状态。 42. - Species for acquiring hyperspectral data from a patient, comprising: a target area on the patient illuminating the tissue; and a detector lens collects the data of the image of the target area; algorithm to the transformed image data optical density units; generates the image of the hypercube; for each percentage of the hypercube calculated spectra oxygen saturation; and determining a state of shock.
43. —种用于从病人获取超光谱数据的方法,包括: 照明所述病人的皮肤上的目标区域; 用摄像机收集所述目标区域的数据图像; 利用算法将所述数据图像转化为光学密度单位; 生成所述数据图像的超立方体;对于所述超立方体中的每一个光谱计算氧饱和度百分比; 监测所述超立方体中的每一个光谱的氧饱和度百分比随时间的变化;以及确定休克状态。 43. - kind of hyper-spectral data for obtaining from a patient, comprising: a target area on the patient's skin illuminating the; with a video camera to collect data of the image of the target area; algorithm using the data of the image is converted to an optical density units; generates the image hypercube; for the hypercube calculated spectra for each percentage oxygen saturation; percentage change in oxygen saturation monitor the hypercube each spectrum over time; and determining shock state.
44. 一种用于从病人获取超光谱数据的方法,包括: 照明所述病人的组织上的目标区域; 用透镜和检测器收集所述目标区域的数据图像; 利用算法将所述数据图像转化为光学密度单位; 生成所述数据图像的超立方体;对于所述超立方体中的每一个光谱计算氧合血红素和脱氧血红素系数;以及确定休克状态。 44. A hyperspectral data acquired from the patient's method, comprising: a target area on the patient illuminating the tissue; and a detector lens collects the data of the image of the target area; algorithm to the transformed image data optical density units; generates the image of the hypercube; for the hypercube each calculated spectra oxyhemoglobin and deoxyhemoglobin coefficients; and determining a state of shock.
45. —种用于从病人获取超光谱数据的方法,包括: 照明所述病人的皮肤上的目标区域;用摄像机收集所述目标区域的数据图像;利用算法将所述数据图像转化为光学密度单位;生成所述数据图像的超立方体;对于所述超立方体中的每一个光谱计算氧合血红素和脱氧血红素系数;监测所述超立方体中的每一个光谱的氧合血红素和脱氧血红素系数随时间的变化;以及确定休克状态。 45. - kind of hyper-spectral data for obtaining from a patient, comprising: a target area on the patient's skin illuminating the; with a video camera to collect data of the image of the target area; algorithm using the data of the image is converted to an optical density units; generates the image hypercube; for the hypercube each calculated spectra oxyhemoglobin and deoxyhemoglobin coefficients; monitoring the hypercube each spectrum oxyhemoglobin and deoxygenated hemoglobin Prime coefficient changes with time; and determining a state of shock.
46. —种用于获取休克数据的设备,其用于超光谱成像,所述设备包括如下部件至少之一:检测器; 功率源;一组或多组LED光;和图像获取硬件。 46. - kind of shock device for obtaining data for hyperspectral imaging, said device comprising at least one of the following components: a detector; a power source; one or more groups of LED light; and image acquisition hardware.
47. 根据权利要求46所述的设备,其中所述LED光是2—100nm的窄带LED。 47. The apparatus according to claim 46, wherein the LED light 2-100nm narrowband LED.
48. 根据权利要求46所述的设备,其中存在一个或两个提供可见光和NIR光的感测的检测器。 48. The apparatus according to claim 46, wherein the presence of one or two to provide visible and NIR light sensing detector.
49. 根据权利要求46所述的设备,其中所述透镜被调谐用于可见波长和NIR波长。 49. The apparatus according to claim 46, wherein said lens is tuned to the wavelength of the visible and NIR wavelengths.
50. 根据权利要求46所述的设备,其中窄带是指50nm以下的带宽。 50. The apparatus of claim 46, wherein the narrow bandwidth of 50nm or less means.
51. 根据权利要求46所述的设备,其中所述设备还包括光控制器和运行系统控制的计算机。 51. The apparatus according to claim 46, wherein said apparatus further comprises a light controller and a computer-controlled operating system.
52. 根据权利要求46所述的设备,其中所述图像获取硬件包括数据获取和预处理软件。 52. The apparatus according to claim 46, wherein the image acquisition hardware including data acquisition and pre-processing software.
53. 根据权利要求46所述的设备,其中所述一组或多组LED光分别具有自己的中心发射波长和自己的发射带宽。 53. The apparatus according to claim 46, wherein said one or more groups each having its own LED light emission center wavelength and its transmission bandwidth.
54. 根据权利要求46所述的设备,其中所述一组或多组LED光的每组都包括以围绕所述透镜的环形模式分布的LED,允许对ROI上均匀或者接近均匀的照明。 54. The apparatus according to claim 46, wherein each of said one or more sets of LED light are included to surround the annular lens pattern distribution LED, allowing uniform or near uniform illumination on ROI.
55. 根据权利要求46所述的设备,其中所述一组或多组LED光由照明器控制器接通和关断。 55. The apparatus according to claim 46, wherein said one or more sets of LED light by the lighting controller turns on and off.
56. —种检测生理状态或休克的方法,包括: 在病人的组织上限定目标区域;在设定间隔的时间段期间以不同的波长范围照明所述目标区域;在照明期间和没有照明的时间段期间用超光谱成像设备收集一系列图以足以检测代谢状况的数据变化的频率重复所述照明和收集步骤;以及处理所述数据变化,以生成超立方体。 56. - species or the physiological state of shock detection method, comprising: defining a target area on the patient's tissue; interval during a time period set in different wavelength ranges illuminate the target area; and no lighting during the lighting time During the segment was collected by a series of graphs hyperspectral imaging device to detect the metabolic state of the data is sufficient to change the frequency of repeating the illumination and collection step; and processing the data changes, in order to generate hypercube.
57. 根据权利要求56所述的用于检测生理状态或者休克的方法,其中所述组织是前臂皮肤、前额皮肤、颊皮肤、口腔黏膜、直肠黏膜或者绒膜。 57. The method for detecting shock or physiological state according to claim 56, wherein said tissue is the skin of the forearm, forehead skin, cheek skin, oral mucosa, rectal mucosa or chorionic.
58. 根据权利要求56所述的用于检测生理状态或者休克的方法,其中所述波长区域为约500 — 1000nm。 58. The method for detecting physiologic state or shock according to claim 56, wherein the wavelength region from about 500 - 1000nm.
59. 根据权利要求56所述的用于检测生理状态或者休克的方法,其中所述波长区域为约500 —600nm。 59. A method for detecting shock or physiological state according to claim 56, wherein the wavelength region of about 500 -600nm.
60. 根据权利要求56所述的用于检测生理状态或者休克的方法,其中所述波长区域为约950 — 1100nm。 60. A method for detecting shock or physiological state according to claim 56, wherein the wavelength region from about 950 - 1100nm.
61. 根据权利要求56所述的用于检测生理状态或者休克的方法,其中所述一系列图像由CCD或者CMOS摄像机收集。 61. The method for detecting shock or physiological state according to claim 56, wherein the series of images collected by a CCD or CMOS camera.
62. 根据权利要求56所述的用于检测生理状态或者休克的方法,其中处理数据的步骤包括对于所述图像中的每一个像素计算氧饱和度值。 62. The method for detecting shock or physiological state according to claim 56, wherein the step of processing the image data comprises for each pixel to calculate the oxygen saturation value.
63. 根据权利要求56所述的用于检测生理状态或者休克的方法,其中处理数据的步骤包括对氧合血红素和脱氧血红素光谱分量进行组合。 63. The method for detecting shock or physiological state according to claim 56, wherein the step of processing data includes oxyhemoglobin and deoxyhemoglobin spectral components are combined.
64. 根据权利要求56所述的用于检测生理状态或者休克的方法,其中处理数据的步骤包括获取在615-710 nm范围内的红区域中的波长和在约550-580 nm范围内的黄区域中的或者在约580-615nm范围内的橙色域中的波长之间的比值。 64. The method for detecting shock or physiological state according to claim 56, wherein the step of processing data comprises obtaining the range of 615-710 nm in the red region and in the wavelength range of about 550-580 nm yellow The ratio in the range of about 580-615nm wavelength range between orange domain or region.
65. 根据权利要求56所述的用于检测生理状态或者休克的方法,其中处理数据的步骤包括去除环境光贡献并且评估每单位时间的反射强度,其中,对于每一个设定波长,从在有照明的情况下记录的图像中减去在没有照明的情况下记录的图像。 65. The method for detecting shock or physiological state according to claim 56, wherein the step of processing the data includes removing an ambient light contribution and evaluate the reflected intensity per unit time, which is set for each wavelength, from there in case illuminated images recorded by subtracting without illumination recorded image.
66. 根据权利要求56所述的用于检测生理状态或者休克的方法,其中处理数据的步骤包括按照对所得到的标准化HSI图像强度对所记录的参比标准化强度的比值以IO为底取对数,来计算吸光度值。 66. The method for detecting shock or physiological state according to claim 56, wherein the step of processing the data in accordance with standardized comprises HSI image intensity ratio of the obtained reference standardized intensity is recorded to the end taking the IO number to calculate the absorbance values.
67. 根据权利要求56所述的用于检测生理状态或者休克的方法,其中处理数据的步骤包括在每一个设定时间段执行图像套准。 67. The method for detecting shock or physiological state according to claim 56, wherein the step of processing the data comprises performing a set period of time in each image registration.
68. 根据权利要求56所述的用于检测生理状态或者休克的方法,其中处理数据的步骤包括执行在两个用于NIR波长和可见波长的值的独立检测器之间的图像套准。 68. The method for detecting shock or physiological state according to claim 56, wherein the step of processing the data includes performing image registration between two separate detectors for the NIR and visible wavelengths of the wavelength values.
Description  translated from Chinese

在全身生理学和休克的判定、评估和监测中的超光谱/多光谱成像本发明中涉及的权利本发明部分地在Technologies for Metabolic Monitoring 2002, DAMD 17-02-1-0714禾口Combat Casualty Care Research Program, US Army Medical Research and Material Command的资助下由美国政府支持完成,在本发明中美国政府可能具有某些权利。 Systemic physiology and shock decision, assessment and monitoring of hyperspectral / multispectral imaging of the present invention relates to a part of the present invention as claimed in Technologies for Metabolic Monitoring 2002, DAMD 17-02-1-0714 Hekou Combat Casualty Care Research Program, funded by US Army Medical Research and Material Command completed by the US government support, in the present invention, the US government may have certain rights. 相关申请的引用本申请要求如下申请的优先权:2004年12月28日递交的题为"Hyperspectral Imaging in Shock Prediction and Survivability Assessment"的美国临时专利申请No. 60/639,315; 2004年12月28日递交的题为"Hyperspectral Imaging: A New Approach to the Diagnosis of Hemorrhagic Shock"的美国临时专利申请No. 60/639,282; 2005年2月16日递交的题为"Hyperspectral Shock Index"的美国临时专利申请No. 60/653,082;以及2005年2月16日递交的题为"Hyperspectral Vital Sign Monitor"的美国临时专利申请,这些申请中的每一篇通过引用被全文包括于此。 REFERENCE TO RELATED APPLICATIONS This application claims priority to an application: December 28, 2004 filed entitled "Hyperspectral Imaging in Shock Prediction and Survivability Assessment" of U.S. Provisional Patent Application No. 60 / 639,315; 2004 年 12 月 28 日Submit entitled "Hyperspectral Imaging: A New Approach to the Diagnosis of Hemorrhagic Shock" of U.S. Provisional Patent Application No. 60 / 639,282; 2005 年 2 月 16 filed entitled "Hyperspectral Shock Index" of U.S. Provisional Patent Application No 60 / 653,082; US provisional patent applications, and February 16, 2005, filed entitled "Hyperspectral Vital Sign Monitor", and each one of these applications are hereby incorporated herein by reference. 技术领域本发明涉及用于执行对一个或者多个生理参数的实时和/或接近实时的评估和监测的超光谱或多光谱成像系统和设备。 The present invention relates to the implementation of one or more physiological parameters in real time and / or near real-time assessment and monitoring of hyperspectral or multispectral imaging systems and devices. 本发明还涉及分析超光谱和多光谱数据以在例如休克和濒临休克、血容量过低、血液动力学功能障碍、生理功能紊乱、脱水和体温过低中提供具体的诊断和治疗选项。 The present invention also relates to the analysis of hyperspectral and multispectral data to, for example, on the verge of shock and shock, hypovolemia, hemodynamic dysfunction, physiological disorders, dehydration and hypothermia provide specific diagnoses and treatment options. 背景技术对不管何种病源学的新陈代谢休克的早期检测对于各种民事和军事医疗环境是至关重要的。 Background Early detection matter what the etiology of metabolic shock for a variety of civilian and military medical environment is essential. 急性出血和随后的循环衰竭(休克)占战场上和前线手术台(forward operating table)的死亡人数的约50%,该统计数字自从第一次世界大战以来一直相对保持不变。 Acute hemorrhage and subsequent circulatory collapse (shock) on battlefields and front lines representing the operating table (forward operating table) in about 50% of deaths, the statistics since World War I has been relatively unchanged. 此外,出血在死于受伤的受伤士兵的约30%中是主要的死亡原因。 In addition, the bleeding is the leading cause of death in about 30% of the wounded soldiers died of injuries in. 类似地,在民事领域,无控制出血占外伤引起的早期手术死亡的高达82%。 Similarly, in the civil field, uncontrolled bleeding accounted for early surgical trauma caused by the death of up to 82%. 但是,如果通过外科手术稳定外伤病人,则在战争人员伤亡中的死亡率下降到2%到4%。 However, if surgical stable trauma patients, the mortality rate of casualties in the war in the fall to 2% to 4%. 因此显然,提供对于休克的早期诊断的能力显著降低了民事和军事环境中与休克相关的死亡率和发病率。 Clearly therefore, the ability to provide for early diagnosis of shock significantly reduced the civilian and military environments with shock-related mortality and morbidity. 出血性休克一般由血压过低的程度、非特异性征候和主观症状(诸如由于失血而发展的皮肤湿冷、脸色苍白、脉搏弱且浅、不稳定的生命迹象以及精神消退)来确定。 Hemorrhagic shock generally consists of low blood pressure level, non-specific signs and subjective symptoms (such as loss of blood and the development of skin clammy, pale, weak pulse and shallow, unstable signs of life and spiritual regression) to determine. 对于其它类型的休克可以观察到类似的症状。 For other types of shock like symptoms can be observed. 休克的影响为供给和需求之间的不匹配,导致各种组织中的细胞代谢改变。 The impact shock is a mismatch between supply and demand, leading to metabolic changes in the cells of various tissues. 所有这些是循环不足以满足代谢需求所导致的。 All of these cycles is insufficient to meet metabolic demands caused. 大家清楚的是,在过了某一点之后,休克变为不可逆的。 We know that in the past a certain point after the shock becomes irreversible. 对于军事应用,特别是在战场中,识别那些期待自然复原的士兵以及那些应该被治疗的士兵是极其有用的。 For military applications, especially in the battlefield, identify those soldiers and those who look forward to the natural recovery of the soldiers should be treated is extremely useful. 对于在各种人体和动物模型中预测濒临血液动力学代偿失调和判定休克的不可逆性的标准的描绘己经作出了重大的努力。 For a variety of human and animal models to predict the verge of hemodynamic decompensation and determine irreversible shock depict standard has made great efforts. 类似地,能够用于评估其它损伤、受到化学或生物试剂的作用、虚脱、脱水、营养状态、精神或情感紧张水平、药剂、受到诸如一氧化碳的毒性剂的作用的信息在战场和民事环境中都将是有用的。 Similarly, can be used to assess other damage by the action of chemical or biological agents, exhaustion, dehydration, nutritional status, mental or emotional stress level, pharmaceutical, by acting agents such as carbon monoxide toxicity information on the battlefield and civilian environments are It would be useful. 适当的治疗类选法和诊断对于潜在的生命救助治疗对策的适当应用是十分关键的。 Appropriate triage and diagnose the potentially life-saving treatment on the appropriate application is very critical. 在受到化学或者生物作用方面,快速和准确地评估受伤或者受影响的个体的血液动力学状态将是至关重要的又是困难的。 In chemical or biological role of being fast and accurate assessment of injuries or hemodynamic status of the affected individual will be crucial and difficult. 笨重的化学生物毒剂(CBW)个人防护装备可能阻碍医疗人员或者急救者(first responder)对于同样可能穿着CBW装备的伤员进行标准评估所需的接触。 Heavy chemical and biological agents (CBW) personal protective equipment may hinder or emergency medical personnel who (first responder) for the same equipment may be wearing CBW wounded criteria for assessing desired contact. 获取脉搏或者测量血压可能是不可能的。 Get pulse or blood pressure measurement may not be possible. 与可能受污染的个体接触的任何装置也可能被污染,并且在没有繁重的清洁措施或者一次性遮盖物的情况下可能不能被再利用。 Any potentially contaminated equipment and individual contact may also be contaminated, and may not be reused without onerous cleansing measures or disposable covering the case. 因此,发展和使用远程感测技术以在这样的环境中提供生理和血液动力学评估,将是非常有利的。 Therefore, the development and use of remote sensing technology to provide physiologic and hemodynamic assessment in such an environment would be very beneficial. 为了最大化的实用性,这样的技术将提供能给出接近实时的信息的手持、耐用并且可随时使用的系统。 In order to maximize the usefulness of this technology will provide near real-time information can be given hand-held, durable and ready to use system. 其将要求最小的操作者技能,并且将可由穿着CBW服装的终端使用者操作。 It will require a minimum of operator skill, and will be wearing clothing CBW end-user operations. 深度酸毒症、碱缺乏或者碱缺乏的变化率已经都被与不可存活性相关联,但是已经公知的是,这些发生在休克进展的后期。 Depth acidosis, base or rate of change of the lack of lack of bases have all been associated with non-viable phase, but already well known is that these occur in late shock progress. 此外,到目前为止,对这些参数的评估需要血液样品和实验设备,这限制了这类测试对于急救者的使用。 Moreover, so far, the assessment of these parameters require a blood sample and laboratory equipment, which limits the kind of testing for first aid use. 其它参数,诸如深度血压过低或者严重心搏徐缓的开始或者其它节律障碍,通常在紧接末期征兆之前的休克中可以被观察到,但是不能可靠地提供足够预先的通知以允许成功的介入。 Other parameters, such as the depth of hypotension or severe bradycardia or other dysrhythmias start, usually immediately before the end of the shock signs can be observed, but not reliably provide sufficient advance notice to allow for successful intervention. 更轻度的血压过低或者节律紊乱可能与存活或者死亡相关,不能提供预兆信息。 More mild hypotension or rhythm disturbances may be associated with survival or death, do not provide prognostic information. 因此, 一直存在对于如下监测设备的需要,该监测设备提供关于病人对于休克的反应的可能后果的更早信息。 Therefore, there has been a need for the following monitoring equipment, monitoring equipment that provide information about the patient's earlier response to the shock of possible consequences. 因为血压过低和氧气传输减小的表现反应了出血性休克的过程中的晚期征兆,因此至关重要的是,确定在血量损失的最早时间段期间改变的生理信号,以提供对于休克严重性的准确评估。 Because hypotension and reduced oxygen transfer performance reflects the process of hemorrhagic shock in the late symptom, it is essential that determined during the earliest period of the change in the amount of blood loss physiological signals, to provide for severe shock accurate assessment of. 在休克发展中的共同特性是与血液流量(心输出量)减小相关的到组织的氧传输不足(D02)或者代谢改变(减小的pH值或者碱过量)。 Common characteristics of shock development is blood flow (cardiac output) decreases related to the organization's lack of oxygen transport (D02) or metabolic changes (decreased pH value or base excess). 增大的心输出量和D02与存活密切相关,而无法稳定心输出量和D02与死亡高度相关。 Increased cardiac output and D02 and survival are closely related and can not stabilize cardiac output and D02 highly correlated with death. 因此,包括某些氧传输的指标(例如,心搏量,心输出量)的手段代表了较之目前用于此目的的测量手段更好的用于循环性休克的早期预测的工具。 Thus, including the indicators (e.g., stroke volume, cardiac output) of some oxygen transmission means represent the current earlier than the measurements for this purpose for circulatory shock better predictive tool. 发明内容本发明克服了与现有方案和设计相关的问题和缺点,并且提供了新的工具和方法,所述工具和方法用于评估休克受害者或者其它需要实时或者接近实时的生理评估的病人的组织氧饱和度、氧输送和氧提取以及组织水合水平。 The present invention overcomes the problems and disadvantages associated with existing programs and design, and provides new tools and methods, the tools and methods used to assess the shock victims or other patients require real-time or near real-time physiological assessment The tissue oxygen saturation, oxygen delivery and tissue oxygen extraction and hydration levels. 该技术利用了通过超光谱成像的局部组织评估,以提供关于全身生理和疾病状态的信息。 The technology uses a hyperspectral imaging by local organizational assessment, to provide information about systemic physiology and disease states. 因此,本发明涉及超光谱和多光谱成像系统、设备和方法,其用于一个或者多个生理参数的实时或者接近实时的评估和监测,所述生理参数包括氧合血红素、脱氧血红素、水含量、总血红素和氧饱和度,其按照本文所述地被分析时,提供代谢和生理状况,诸如休克的出现或者评价、复生的充分性或者生存的可能性。 Accordingly, the present invention relates to a hyper-spectral and multi-spectral imaging systems, devices and methods for one or more real-time or near real-time assessment and monitoring of physiological parameters, the physiological parameters include oxyhemoglobin, deoxyhemoglobin, water content, total hemoglobin and oxygen saturation, which when described herein be analyzed according to provide metabolic and physiological conditions, such as the emergence of shock or evaluation, the possibility of a revival of the adequacy or survival. 从HSI数据得到的具体诊断包括休克,血容量过低,血液动力学障碍,生理紊乱,休克或濒临休克状态(包括括出血性休克、血容量过低休克、败血性休克、心原性休克、神经性休克、烧伤休克的休克或者濒临休克)、脱水和体温下降。 HSI data obtained from specific diagnosis include shock, hypovolemia, hemodynamic disorders, physiological disorder, shock, or on the verge of a state of shock (including including hemorrhagic shock, hypovolemia shock, septic shock, cardiogenic shock, neurogenic shock, burns or shock shock shock verge), dehydration and hypothermia. 微循环变化类似地可以见于诸如糖尿病或者充血性心力衰竭的慢性疾病状态中。 Similarly microcirculation can be found such as diabetes or congestive heart failure, chronic disease states. 例如,在患有神经病的糖尿病受试者的前臂中,组织氧合血红素和氧饱和度(sHSIo2)的超光谱测量结果较低,尽管该区域通常不受临床体神经病的影响(Greenman et al., Lancet 2005; 366: 1711)。 For example, in subjects with diabetic neuropathy forearm, the lower tissue oxygenation of hemoglobin and oxygen saturation (sHSIo2) hyperspectral measurement results, even though the region is generally not subject to the impact of the clinical body neuropathy (Greenman et al ., Lancet 2005; 366: 1711). 该观察涉及了得自通常以足部为目标的疾病的全身微血管变化的超光谱成像。 This observation relates to the body usually terrible from the foot microvascular disease targeted changes hyperspectral imaging. 由超光谱测量提供的类似信息可以支持休克或者其它生理变化的关于其的额外信息的早期检测,并且还提供关于可能的后果的信息。 Similar information provided by hyperspectral measurements can support shock or other physiological changes of early detection of additional information about its, and also provides information about the possible consequences. 利用猪的出血性休克和人的低体负压(LBNP)模型(仿效血损失的人休克模型)的超光谱成像表明了可以用于监测和预测休克的开始和恢复的衡量标准。 The use of pig and human hemorrhagic shock lower body negative pressure (LBNP) model (emulate human blood loss shock model) hyperspectral imaging shows the beginning and metrics that can be used to monitor and predict the shock recovery. 本设备的实施例可以用于如下环境,包括但不限于,手术、临床过程、健康监测、急救室或者战场护理、急救情形和野外医疗评估、医院、以及临床或者医师办公室。 Embodiments of the device can be used in the following environments, including but not limited to, surgery, clinical course, health monitoring, emergency room or battlefield care, emergency situations and field medical evaluation, hospitals and clinical and physician offices. 此技术通过超光谱成像在空间、光谱和时域维度上评估(在第一时间)局部组织,以提供关于全身生理和疾病状态的信息。 This technical assessment of local tissue (the first time), to provide information about systemic physiology and disease states in spatial, spectral and temporal dimension by hyperspectral imaging. 本发明的一个实施例涉及传递MHSI图像以诊断和评价休克的设备, 包括:检测器(例如摄像机);可控光源;光谱分离器;功率源;图像获取和显示硬件,以及由足以将数据转化为可用信息的硬件和软件组成的集成分析系统。 One embodiment of the present invention relates to transfer images to diagnose and evaluate MHSI shock device, comprising: a detector (such as a camera); controllable light source; spectrum splitter; a power source; image acquisition and display hardware, and the sufficient data conversion Integrated analysis systems available hardware and software information thereof. 检测器优选是数字摄像机(例如具有电荷耦合器件(CCD) 或者互补金属氧化物半导体(CMOS)检测器的摄像机)和透镜。 Preferably the detector is a digital camera (e.g., complementary metal oxide semiconductor (CMOS) detector having a charge coupled device (CCD) or camera) and a lens. 优选地,光源是围绕光进入区域布置的发光器件(例如发光二极管(LED)) 阵列,以提供接近同轴的照明,其每一个的强度和持续时间由软件程序控制。 Preferably, the light source is disposed around the light emitting device enters the area (e.g., a light emitting diode (LED)) array, in order to provide close coaxial illumination, each of the intensity and duration controlled by a software program. 优选地,光谱分离器是可见或者近红外波长液晶可调谐滤波器(LCTF),并且被装配到摄像机透镜的前方。 Preferably, the spectral separation is visible or near infrared wavelength liquid crystal tunable filter (LCTF), and is fitted to the front of the camera lens. 优选地,功率源和软件程序被用于供电和控制图像获取硬件。 Preferably, the power source and the software program is for power and control of image acquisition hardware. 优选地,该设备是便携式的并且数据的获取被实时地或者接近实时地执行。 Preferably, the device is portable and acquires data in real time or near real-time execution. 优选地,被检查的组织可以是皮肤,诸如手掌(内)前臂的皮肤。 Preferably, the examination of tissue can be skin, such as the palm of your hand (inner) forearm skin. 两个这样的透镜、滤波器和检测器子系统(一个用于可见波长的收集,另一个用于NIR波长的收集)可以被组合和集成为一个功能系统。 Two such lenses, filters and detector subsystem (one for visible wavelengths collection, another collection of NIR wavelength used) can be combined and integrated into a functional system. 在本发明的另一个实施例中,声光可调谐滤波器(AOFT)被装配在透镜和摄像机之间,或者装配在透镜的前方。 Example, acousto-optic tunable filter (AOFT) is fitted between the lens and the camera or in front of the lens assembly in another embodiment of the invention. 通过经由计算机控制的驱动器改变声波的频率,进行波长选择。 Via a computer controlled by the driver to change the frequency of the acoustic wave, wavelength selection. 取决于所期望的光学设计,可以在摄像机和AOTF之间使用附加的透镜。 Depending on the desired optical design, you can use the additional lens between the camera and AOTF. 在本发明的另一个实施例中,红外温度计被与HSI系统匹配(或匹配在HIS系统内),来测量ROI表面的温度。 In another embodiment of the present invention, the infrared thermometer is the HSI system to match (or matches in the HIS system) to measure the temperature of the surface of the ROI. 该温度计可以被扩展为热敏感器件阵列,其提供被观察表面上的温度分布的数字图像。 The thermometer can be extended to heat-sensitive element array that provides a digital image is observed on the surface temperature distribution. 后者被包括在HSI数据分析中,以确定休克进程的开始。 The latter is included in the HSI data analysis, to determine the start of the process of shock. 本发明的另一个实施例涉及一种用于从病人获取MHSI数据的方法, 包括:照明所述病人的组织上的目标区域;用检测器收集所述目标区域的数据图像;利用算法将所述数据图像转化为光学密度单位;生成所述数据图像的超立方体;对于所述超立方体中的每一个光谱计算如下中的任何一项或者全部:氧合血红素、脱氧血红素和水系数,并且利用这些计算结果得到如下生理相关的参数中的任何一项或者全部:氧输送、氧提取、总血红素、组织超光谱氧饱和度(SHSI02)、以及水合水平。 Another embodiment of the present invention relates to a method for acquiring data from MHSI patient, comprising: a target area on the patient illuminating the tissue; with a detector to collect the data of the image of the target area; the algorithm image data is converted to an optical density units; generates the image of the hypercube; for the hypercube each spectrum as in any one of or all computing: oxyhemoglobin, deoxyhemoglobin and water coefficients, and The results obtained using these physiological parameters related to any of the following or all of: oxygen delivery, oxygen extraction, total hemoglobin, hyperspectral tissue oxygenation saturation (SHSI02), and hydration levels. 这些参数中的任何一项或者全部被用于得到超光谱休克指标。 Any one or all of these parameters are used to obtain hyperspectral shock index. 对于所收集的数据,执行计算以提供关于ROI的化学组成的信息。 For the collected data, perform calculations in order to provide information about the chemical composition of the ROI. 优选地,根据数据来计算代表物质存在浓度的如下系数中的任何一项或者全部:氧合血红素、脱氧血红素和水。 Preferably, the data used to calculate the concentration of the substance is present on behalf of the following factors in any one or all of: oxyhemoglobin, deoxyhemoglobin, and water. 更优选地,对于图像的每一个像素或者对于代表性像素、像素组、ROI的一个区域或者整个ROI,计算氧合血红素和脱氧血红素以及水系数。 More preferably, for each pixel of the image or the representation of the pixels, pixel group, or the whole of a region ROI ROI, to calculate oxyhemoglobin and deoxyhemoglobin and water coefficients. 更优选地,仅仅计算氧合血红素和脱氧血红素系数。 More preferably, just calculation oxyhemoglobin and deoxyhemoglobin coefficients. 系统或者系统的诊断模块使用一个或者多个计算出的系数,以得到关于生理学或者生理状态或者生理紊乱或者病原学的信息。 Diagnostic module system or systems to use one or more coefficients calculated to obtain information about physiology or physiological condition or physiological disorder or etiology. 优选地,这较之被成像的特定一片组织反映了更宽范围的生理学。 Preferably, this is compared to a particular tissue imaged reflect a wider range of physiology. 更优选地,此信息反映了或者与至少区域生理学相关。 More preferably, this information is reflected in the region or at least associated with the physiology. 最优选地,此信息反映了或者与全身生理学或者代谢状态相关。 Most preferably, this information reflects or systemic physiology or metabolism related. 由系统或者系统的诊断模块开发的算法来简化和提供信息。 Diagnostic module by the system or algorithm developed systems to simplify and provide information. 优选地, 这些算法被设计来生成标量指标值或者标量值,其可以与在研究下的生理状态的变化相关或者相关联。 Preferably, these algorithms are designed to generate a scalar index value or scalar value, which can change in the physiological state of the research associated or related. 优选地,这是休克指标。 Preferably, this indicator is shock. 优选地,此指标可以被认为是生命征候,并且充当获取生命征候的代理或者非侵入非接触或者远程方法。 Preferably, this indicator can be considered as signs of life, and to act as agent to obtain life incident or a non-invasive method for non-contact or remotely. 其可以被或者可以不被设计成与目前的标准生命征候(诸如心率或者血压)中的一种紧密相关。 It may or may not be designed to current standards of life symptoms (such as heart rate or blood pressure) in a closely related. 更优选地,休克指标将与血动力学状态的更先进的量度(诸如心输出量、心搏量或者D02)相关。 More preferably, the shock and hemodynamic status indicators will be more advanced metric (such as cardiac output, stroke volume, or D02) related. 最优选地,休克指标将与后果相关。 Most preferably, the shock indicators will be associated with the consequences. 优选地,休克指标将先于其它的衡量标准提供关于病人状况的经改进或者更早的信息。 Preferably, the shock indicators will be improved or provide information about the patient's condition earlier in the other measure. 在另一个实施例中,可以由系统或者系统的诊断模块得到用于其它的疾病或者生理状态的其它指标。 In another embodiment, other indicators can be used for other diseases or physiological condition by the diagnosis module system or systems. 这样的指标的实例包括对于糖尿病、充血性心力衰竭、肾衰竭、液体潴留、脱水、高血压、出血、败血症、肺衰竭、组织缺氧等。 Examples of such indicators include diabetes, congestive heart failure, renal failure, fluid retention, dehydration, high blood pressure, hemorrhage, sepsis, lung failure, tissue hypoxia. 这些可以类似地与目前的与各种生理或者病原状态相关联的测量相关,或者与后果数据相关,以提供经改进的衡量标准。 These can similarly with the current measurement associated with various physiological or pathogenic state related or associated with outcome data to provide an improved measure. 在可选实施例中, 一组反映其本身系数的数字将连同标尺被提供,以允许解释。 In an alternative embodiment, the coefficient reflecting the number itself, along with a set of scales which will be provided to allow for interpretation. 在另一个可选实施例中,相关的信息作为单个或者一系列的黑白或者伪彩色图像被提供,所述图像反映了空间和光谱组织特性两者。 In another alternative embodiment, the relevant information as a single or a series of monochrome or pseudo-color image is provided, the reflected image of both spatial and spectral properties of tissue. 优选地,该图像将与标尺相关联地报告,以允许容易的解释。 Preferably, the image will be reported in association with the scale, in order to allow an easy explanation. 在另一个实施例中,提供代谢状态的单一指示。 In another embodiment, there is provided a single indication metabolic state. 优选地,这是提供给操作者关于病人的状态的信号的一个或者一系列光的形式。 Preferably, this is a form of light or a series of signals to the operator about the status of the patient. 在另一个实施例中,在屏幕上提供语言或者书面指令。 In another embodiment, the provision of language or written instructions on the screen. 图像可以以多种方法中的任何一种来提供,包括MHSI成像仪本身、 在远程屏幕上、通过投影仪或者经由前导显示器。 Images can be any of a variety of methods to provide, including MHSI imager itself, on a remote screen through a projector or monitor via the preamble. 使用预定的光照,或者光照被测量或被估计或被记录。 Using a predetermined light, or lighting is measured or estimated or recorded. 优选地,系统被校准,以考虑环境光照以及由仪器提供的任何光。 Preferably, the system is calibrated to account for ambient lighting and any light provided by the instrument. 确定为必要的校准步骤被自动或者手动或者两者的组合来确认,并且手动或者自动或者以两者的组合来进行实施此校准的步骤。 Identified as necessary calibration steps are automatic or manual, or a combination of both to confirm, and manual or automatic, or a combination of both to implement this calibration step. 优选地,校准步骤被用于评估和使用或者校正环境光。 Preferably, the calibration procedure is used to evaluate and use or correction of ambient light. 在一个优选实施例中,可调谐光源、可调谐滤波器或者这两者被用作光谱分离器,以提供用于分析的特定光谱数据。 In a preferred embodiment, a tunable light source, tunable filters or both are used as spectral splitter, to provide specific spectral data for analysis. 在另一个优选实施例中,特定波长光源,优选LED,被用于提供数据输入,并且消除了对于光谱分离器或者滤波器中的一些或者全部的需要。 In another preferred embodiment, a specific wavelength light source, preferably LED, it is used to provide data entry and eliminating the need for spectral separator or filter some or all of the needs. 优选地,在数据收集过程中的全程或者一部分中,为设备提供光照。 Preferably, the whole or part of the data collection process in order to provide illumination device. 更优选地,仪器提供预定的光照。 More preferably, the instrument provides a predetermined illumination. 优选地,仪器至少收集一组仅用环境光的数据。 Preferably, at least one set of instruments to collect data only ambient light. 此数据组可以是单波长带收集或者由设备所测量的整个波长带的的全部或者部分。 This data set can be collected by a single wavelength band, or the entire wavelength measured by a device with all or part of the. 在另一个实施例中,环境光被用作光源,并且设备进行测量以用于校准。 In another embodiment, the ambient light is used as a light source, and for calibration of the measurement equipment. 优选地,如果环境光不足,操作者将被告知。 Preferably, if the ambient light is insufficient, the operator will be informed. 最优选地,如果环境光不足,其将手动地或者自动地或者以两者的组合的方式被来自仪器的光照补充。 Most preferably, if the ambient light is insufficient, it will be manually or automatically or in a combined manner both from the instrument light supplement. 在随后的说明书中部分地阐述了本发明的其它实施例和优点,其部分地将通过该说明书而变得清楚,或者可以通过对本发明的实施而被教导。 In the following part of the specification describes the other embodiments and advantages of the present invention, the part will become apparent from the description, or may be by practice of the invention are taught. 附图说明图1是具有光分离器的HSI系统。 Figure 1 is a HSI system having a light splitter. 图2是具有预定波长的光的HSI系统。 Figure 2 is a predetermined wavelength of HSI system. 可以使用窄带LED,使得不再需要光谱分离器。 You can use the narrow-band LED, so no need spectrum splitter. 图3是皮肤中的主要发色团的可见和近红外(NIR)吸收光谱:水(蓝色)、氧合血红素(红色)、以及脱氧血红素(绿色)。 Figure 3 is a visible skin main chromophore and near-infrared (NIR) absorption spectrum: water (blue), oxyhemoglobin (red) and deoxygenated hemoglobin (green). 图4是利用可视MHSI,在超立方体(hypercube)的一个像素处记录的手掌(左侧图)的彩色图像和谱图(右侧图)。 Figure 4 is the use of visual MHSI, in hypercube (hypercube) recorded at a pixel palm (left panel) color images and spectra (right panel). 所记录的谱图(黑色实线)被分解成4个分量(偏移量、斜率、氧合血红素和脱氧血红素),使得当合成复原时,它们形成以最少方差方式与真实数据拟合的线(黑色虚线)。 The recorded spectra (solid black line) is broken down into four components (offset, slope, oxyhemoglobin and deoxyhemoglobin), so that when the synthetic recovery, they form with minimal variance with the real data fitting manner The line (black dashed line). 图5是猪受试者的SHS!02图像中的像素强度的直方图。 Figure 5 is a pig subjects SHS! 02 histogram of pixel intensities in the image. 这些线示出了在基线处(蓝色)和在休克过程中(绿色)皮肤中的S服02值的分布。 These lines are shown at baseline (blue) and distribution (green) skin suit 02 S values in shock process. 平均值的减小提供了休克的清楚提示。 Reducing the average provides a clear prompts shock. 图6是在血压被降低到-90 mm Hg时在对人类受试者的LBNP实验过程中的心率(红色)和平均THb (对ROI平均的总血红素)(蓝色)。 Figure 6 is a blood pressure is lowered to -90 mm Hg to LBNP experiment in human subjects in heart rate (red) and the average THb (ROI average for total hemoglobin) (blue). 在t=0时发生昏厥并且返回到0 LBNP。 At t = 0, fainting and returns to 0 LBNP. 在虚脱之前总Hb急剧下降。 Prostration before the sharp decline of total Hb. 图7是在血压被降低到-90 mm Hg时在对人类受试者的LBNP实验过程中的心率(红色)和std (在ROI内S腦02的标准差)(蓝色)。 Figure 7 is a blood pressure is lowered to -90 mm Hg to LBNP experiment in human subjects in heart rate (red) and std (S brain in ROI within 02 standard deviation) (blue). 在t= 0时发生昏厥并且返回到0 LBNP。 At t = 0, fainting and returns to 0 LBNP. 在虚脱之前SH^02的不均匀性增大。 SH ^ 02 before the collapse of the non-uniformity increases. 图8是在血压被降低到-90 mm Hg时在对人类受试者的LBNP实验过程中的对ROI平均的皮肤水合(蓝色)和LBNP (绿色)。 Figure 8 is a blood pressure is lowered to -90 mm Hg in LBNP experiment on human subjects in the process of ROI average skin hydration (blue) and LBNP (green). 在t二0时发生昏厥并且返回到0LBNP。 Fainting at t 20 to time and return an 0LBNP. 在此研究中,在虚脱之前组织水合下降了几乎腦。 In this study, before the collapse fell almost brain tissue hydration. 图9是示出了图像过滤如何能够被用于提供对于皮肤色斑的自动检测的原始图和经处理的图像。 FIG. 9 is a diagram showing how image filtering can be used to provide images for automatic detection of skin pigmentation of the original image and processed. 图10是在图像中BLOBS和TEMPORALS (绿色和蓝色,下方的图) 具有的特征。 FIG. 10 is in the image BLOBS and TEMPORALS (green and blue, the bottom of the chart) has features. BLOBS定量"色斑"或者"斑点" 一伴随休克出现的SHSI02的大的空间变化。 BLOBS quantitative "stain" or "spot" a large space accompanied by changes in SHSI02 shock arise. TEMPORAL对从一个时间点到下一个时间点的"色斑"图案的时域变化进行定量。 TEMPORAL point from one time to the "splash" pattern to the next point in time to quantify temporal changes. 在许多例子中,TEMPORAL的增大先于BLOBS的增大。 In many instances, TEMPORAL increases the first increases in BLOBS. 图ll表明MHSI氧合血色素(OxyHb)揭示了作为病人可存活性的指示的循环模式的变化。 Figure ll show MHSI oxygenation hemoglobin (OxyHb) reveals the change as an indication of patient survivability of circulation patterns. OxyHb图像示出了在动物休克实验的过程中的变化:左侧的是基线处(在最初出血之前),中间的是在休克期间(在最初出血之后62分钟),右侧的是在复生后平衡态(在最初出血之后147分钟)。 OxyHb images shows the change in the course of animal experiments in shock: the left is at baseline (prior to the initial bleeding), is in the middle after resuscitation during shock (62 minutes after the initial bleeding), the right side is equilibrium (at 147 minutes after the initial bleeding). 其它的猪表明了在复生后基线模式的完全恢复。 Other pigs showed a full recovery after the resurrection baseline model. 图12表明MHSI S舰02揭示了作为病人可存活性的指示的循环模式的变化。 Figure 12 shows the ship MHSI S 02 patients revealed the change as an indication of the viability cyclic pattern. S服02的基线(左侧图)与休克图像(右侧图)的比较示出了"羽毛状"图案的发展。 S serving 02 baseline (left panel) and shock image (right panel) shows a comparison of the development of "feathery" pattern. 这类图案在许多或者在此过程中死亡或者针对测试过程没有显现出强劲恢复的动物受试者中发展,并且看起来表明获得不利后果的更大可能性。 Such a pattern in many or death during this process or procedure for testing did not show a strong recovery in the development of animal subjects, and it seems that indicate the possibility of obtaining a greater negative consequences. 图13示出了对于每一个时间步长的作为时间的函数的生理和超光谱参数的平均值,同时还示出了标准差。 Figure 13 shows a long and hyperspectral physiological parameters as a function of time of the average value for each time step, and also shows the standard deviation. 心率和血压示于左侧两个图中。 Heart rate and blood pressure are shown in the left side of the two figures. 利用平均、分布、斑点和时域偏移方法得到的结果被示于右侧的图中。 Using the average, the distribution, the results of spot and time domain migration methods are shown in Figure on the right. 对照受试者和出血受试者分别由蓝色和黑色示出。 Bleeding control subjects and the subjects are shown by the blue and black. 图14示出了接收工作特性(ROC)曲线,以及心率(红色)、动脉收縮血压(蓝色)、和超光谱休克指标HSSI (黑色)在ROC曲线下的面积,同时还示出了标准差。 Figure 14 shows the receiving operating characteristic (ROC) curve, and heart rate (red), systolic arterial blood pressure (blue), and shock index HSSI (black) area under the ROC curve, and also shows the standard deviation hyperspectral . 图15示出了通过CBW面罩的超光谱数据收集。 Figure 15 shows the mask by CBW hyperspectral data collection. 从顶侧到底侧:1) 由目标区域的超光谱图像重构的彩色照片;2)示出了预期的不均匀性的通过面罩透镜得到的谱图;3)具有空间变化的未套准的"原始"光谱图像,其在图像处理算法中是有利的。 From the top side in the end side: 1) color photograph by the hyper-spectral reconstructed image of the target area; 2) shows the expected unevenness spectra obtained through the mask lens; 3) spatial variation of non-registration "Original" spectral image, which is advantageous in image processing algorithms. 注意,反射闪光不影响分析。 Note bounce flash does not affect the analysis. 具体实施方式光谱学已经被用于检测各种组织中的代谢状态。 DETAILED DESCRIPTION spectroscopy has been used to detect a variety of tissue metabolism. 例如,光谱分析方法被结合在脉搏血氧计中,脉搏血氧计利用不同的氧合-和脱氧血红素的吸收带来估算全身动脉氧饱和度。 For example, spectral analysis method is incorporated in pulse oximeters, pulse oximeter with different oxygenation - and absorb deoxyhemoglobin brings estimate systemic arterial oxygen saturation. 但是,由脉搏血氧计提供的测量不足以作为诊断或者监测休克的方法。 However, measurements provided by the pulse oximeter is not sufficient as a diagnostic or monitoring shock methods. 虽然脉搏血氧计可以提供动脉氧饱和度的点测量,但是其不能提供对于总血红素或者组织氧提取或者组织水合的测量。 Although pulse oximeter can provide some measure arterial oxygen saturation, but it does not provide for total hemoglobin or tissue oxygen extraction or hydration measurement organization. 因此,脉搏血氧计仅仅提供对与休克相关的生理状态和血液动力学条件进行评价所必须的信息中的一部分。 Thus, the pulse oximeter provides only physiological state associated with shock and hemodynamic conditions necessary for the evaluation of the information part. 因为总血红素的降低或者氧传输和氧提取之间的失配或者皮肤循环模式承载了重要信息并且可能是重要的警告信号,所以这是具有重要影响的。 Because the mismatch or skin circulation mode reduces or oxygen transport and oxygen extraction between total hemoglobin carries important information and may be important warning signal, so this is an important influence. 脉搏血氧计所得到的动脉氧饱和度实际上提供了更多关于肺部而不是循环功能信息,并且动脉饱和度可以被保持直到深度休克晚期,尤其是如果病人一直吸取高浓度氧的话。 Arterial oxygen saturation by pulse oximeter was actually provides more information about the lungs rather than the circulation of information, and arterial saturation depth can be maintained until late shock, especially if the patient has a high concentration of oxygen to learn the words. 确定循环和/或到组织的灌注的充分性另一个重要参数是组织的氧提取。 OK circulation and / or to the adequacy of tissue perfusion another important parameter is the tissue oxygen extraction. 通过记录氧合血红素和脱氧血红素两者的信息并通过使用其来(分别)报告关于氧传输和氧提取两者的信息,医学超光谱成像(MHSI-在此本领域技术人员将其理解为是指医学多光谱成像或者超光谱成像,或者医学多光谱和超光谱成像两者)报告组织代谢和组织灌注的充分性,以维持组织健康和生存能力。 By recording both oxyhemoglobin and deoxyhemoglobin information and by using it to (respectively) report information about the extraction of both oxygen transport and oxygen, medical hyperspectral imaging (MHSI- in this skilled in the art to understand to mean medical multispectral imaging or hyperspectral imaging, or medical multi-spectral and hyperspectral imaging both) Adequacy Report tissue metabolism and tissue perfusion to maintain the health and viability of the organization. 利用两项信息,由MHSI数据计算出的组织OxyHb和DeoxyHb血红素水平,可以传递关于组织氧饱和度(S腦02)和总血红素的信息。 Use two pieces of information, data calculated by the MHSI organization OxyHb and DeoxyHb hemoglobin level, you can pass information on tissue oxygen saturation (S brain 02) and total hemoglobin. 由MHSI数据计算出的水水平可以传递关于组织的水合状态的信息。 MHSI data calculated by the water level can transmit information about the organization's hydration status. 在休克状态中,超光谱成像的模式也可用于揭示人体对血液动力学障碍的反应。 In a state of shock, the hyperspectral imaging mode can also be used to reveal the body's response to hemodynamic impairment. 在人体对血容量过低的反应中,为了集中血流,血液通常在该过程的非常早期被分流远离皮肤。 In the human body's response to hypovolemia, in order to concentrate blood flow, blood is usually very early in the process is diverted away from the skin. 因此,通过监测皮肤及其微循环模式或水合状态,我们可以较早地获得关于血液动力学障碍的严重性的信息。 Therefore, by monitoring the skin and the micro-circulation mode or hydration status, we can get early information about the severity of hemodynamic disorders. 可以类似地评估涉及其它疾病(诸如糖尿病,全身感染或者心脏或肺部疾病)的微循环变化。 Similarly assessment involves other diseases (diabetes, systemic infection or heart or lung disease such as) the microcirculation. 通过类似方法可以确认、评估或者跟踪其它急性或者慢性生理或者代谢变化(Greenmanetal, Lancet 2005; 366: 1711)。 A similar approach can identify, evaluate, or track other acute or chronic physiological or metabolic changes (Greenmanetal, Lancet 2005; 366: 1711). 组织图像中的变化反映了涉及区域血流和水合的全局变化和局部变化、以及与在检查下的微循环床的特异反应相关的更局部的变化。 Tissue image changes reflect changes in the global and local change involves regional blood flow and hydration, as well as more local variations specific response in check under the bed of the microcirculation related. 不同组织或者微循环床之间(例如,皮肤对颊黏膜,或者来自诸如前臂的外周位置的皮肤对来自诸如胸壁的更中心位置的皮肤)的反应的比较及其随时间的相对变化提供了额外的信息。 Among different organizations or microcirculation bed (for example, the skin of the buccal mucosa, or skin from the outer periphery of the skin, such as the forearm from a more central location such as the chest wall) is relatively reactions and provides additional time with the relative change information. 在医院环境中,可以进行大量的测量来监测休克。 In the hospital environment, you can make a lot of measurements to monitor shock. 通过基于血压和血液的氧携带能力的明显下降,心率的升高以及脉搏特性的变化,监测朝向循环虚脱的进程。 By decreased oxygen carrying capacity of blood pressure and blood-based changes and increased heart rate, pulse characteristics, monitoring progress towards the circulation collapse. 存在几种缓冲对抗血压和氧携带能力的变化的补偿机制,限制了这些测量用于休克的早期评估的用途。 There are several buffer against changes in blood pressure and oxygen-carrying ability of the compensation mechanism, limiting the use of these measurements are used to shock the early assessment. 血压过低和休克的其它信号和症状的出现并不标志着循环障碍的开始,而是表示代偿失调的开始,即可能对于引入有效治疗来说太迟的时间点。 Low blood pressure and other signs and symptoms of shock does not mark the beginning of circulatory disturbance, but indicates the start of decompensation, which may be too late point in time for the introduction of effective treatment. 另一个标准生命信号,心率,众所周知地是休克的非特异性指标。 Another standard vital signs, heart rate, it is known to be non-specific indicator of shock. 可能不能确切地解释在受伤士兵或者受伤病人中升高的脉搏速率,这是因为"战或逃(fight-or-flight)"反应是自然的竞争结果。 Could not explain exactly soldiers wounded or injured patients in elevated pulse rate, this is because "fight or flight (fight-or-flight)" is the natural reaction of the competition results. 在战争中或者对于更常规的救护车或者急救室环境中的最初或者早期急救者而言,更侵入或更全面的测量是不现实的。 In war or for more conventional ambulance or emergency room environment or early first aid is concerned, more invasive or more comprehensive measure is unrealistic. 在这些环境中,例如可能不能实施侵入监测, 诸如肺动脉(Swan-Ganz)导管插入(其提供对于血液气体和心输出量的测量)。 In these environments, such as intrusion detection might not be implemented, such as the pulmonary artery (Swan-Ganz) catheterization (which provides for blood gases and cardiac output measurement). 因此,在军事和民事领域两者中,存在对于小型、非侵入并且便携的测量系统的需要。 Thus, in both the military and civilian fields, a need exists for small, non-invasive and requires portable measurement system. 可以利用例如经皮氧分压和/或二氧化碳分压(PtC02/C02)完成对血液气体的非侵入测量。 You can use such as transcutaneous oxygen and / or carbon dioxide partial pressure (PtC02 / C02) to complete the non-invasive measurement of blood gases. 这样的测量的一个缺点是,其依赖于小的样品量, 该小的样品量不能精确地反映整体的组织状况。 One disadvantage of such a measurement is that it relies on a small sample size, the small sample size does not accurately reflect the overall health of the organization. 此外,在皮肤上放置探针本身改变了血流和生理学。 In addition, placing the probe itself and physiological changes in blood flow in the skin. MHSI数据还可以与由如下的测量中的一种或其组合提供的数据结合:皮肤温度、核心温度、心率、RR间期变化、动脉血压、呼气末二氧化碳、tcP02、颅多普勒、脉搏血氧测量、激光多普勒、超声、NIR点光谱分析、神经传导、心输出量、心搏量、中心静脉压、肺动脉压、肺毛细血管楔压、组织水合测量、以及诸如pH和乳酸之类的血液化学值,以便为护理者提供额外的信息,提高诊断准确性或者传达对于生理状态的改变的或者濒临休克的更早警告。 MHSI data may also be provided with the data measured by the following combination of one or a combination: between skin temperature, core temperature, heart rate, RR change period, arterial blood pressure, end-tidal carbon dioxide, tcP02, transcranial Doppler, pulse oximetry, laser doppler, ultrasound, NIR point spectroscopy, nerve conduction, cardiac output, stroke volume, central venous pressure, pulmonary artery pressure, pulmonary capillary wedge pressure, tissue hydration measurements, such as pH and lactic acid as well as the blood chemistry values of class in order to provide additional information for the caregiver to improve diagnostic accuracy or communicate a change in the physiological state or even earlier warning on the verge of shock. 皮肤是用于监测的特别好的选择。 The skin is a particularly good choice for monitoring. 除了其容易适用于基于摄像机的技术(诸如MHSI)之外,皮肤微循环还对休克和其它全身疾病状态具有被良好认识的反应。 In addition to its easily adapted to camera-based technologies (such as MHSI) outside skin microcirculation also a state of shock and other systemic diseases have been a good understanding of the reaction. 通过监测皮肤,MHSI可以跟踪由于包括失血、血液稀释、组织水量的增加或者血液从皮肤分流以保护到中心器官的血流在内的原因导致的、与血液或者红细胞量的疾病相关的变化。 By monitoring skin, MHSI can trace Since include blood loss, hemodilution, blood or tissue to increase the amount of water diversion from the skin to the blood center to provide reasonable protection organs, including the cause of, or red blood cells associated with blood volume changes in disease. 还可以获得关于植物性神经系统的反应的信息,植物性神经系统对于皮肤微循环具有特异性影响,并且可以提供关于身体反应以及损伤或者疾病状态的起因和严重性的额外信息。 Also available on the autonomic nervous system response information, autonomic nervous system is specific for the skin microcirculation impact, and may provide additional information on the cause and severity of the injury on the body and the reaction or disease state. 对于不同的疾病状态、不同的休克形式或者对于特定的有机体的败血性休克的情况,这可能是不同的。 For different disease states, different forms of shock, or for a particular situation organism of septic shock, which may be different. 用MHSI进行的皮肤测量可以用于得到关于氧传输、氧提取和水合水平的信息(其可以被其次地用于评价与诸如休克和糖尿病的各种疾病状态相关的生理学)。 Skin can be measured by MHSI for obtaining oxygen transport, oxygen extraction and hydration level of information about (which can be used to evaluate and followed various disease states such as diabetes-related shock and physiology). 氧合血红素(OxyHb)、脱氧血红素(DeoxyHb)以及水系数可以被独立地表现为图像或者反应目标区域(ROI)上的平均值的标量,或者氧合血红素和脱氧血红素系数可以被用于计算超光谱组织氧饱和度(SHSI02 = OxyHb/(OxyHb + DeoxyHb))、总血红素。 Oxyhemoglobin (OxyHb), deoxyhemoglobin (DeoxyHb) and water coefficient can be expressed as an image or independently reaction target region (ROI) on scalar mean, or oxyhemoglobin and deoxyhemoglobin coefficients may be used to calculate hyperspectral tissue oxygen saturation (SHSI02 = OxyHb / (OxyHb + DeoxyHb)), total hemoglobin. 该信息可以被表现为黑白色或者伪彩色图像,或者氧合血红素和脱氧血红素值(或者它们的与氧提取和输送相等价的组合)可以以诸如血压(eg XX/YY)的格式被表示在一起。 This information can be represented as black and white or pseudo-color image, or oxyhemoglobin and deoxyhemoglobin values (or a combination thereof and oxygen extraction and delivery of equal value) may form such as blood pressure (eg XX / YY) is He expressed together. 这样的表示可以用来代表ROI中的任何像素的氧合血红素和脱氧血红素值,表示整个ROI上或者ROI的任何子部分上的平均氧合血红素和脱氧血红素值,或者氧合血红素和脱氧血红素值可以通过公式或者算法被组合成一个数值(例如,超光谱休克指数)。 Such representation may be used to represent any oxyhemoglobin and deoxyhemoglobin values of pixels in ROI indicates the average oxyhemoglobin and deoxyhemoglobin values over the entire ROI or ROI on any sub-section, or red blood oxygenation Su and deoxyhemoglobin values may be combined by formula or algorithm to a value (for example, hyperspectral shock index). 在这些阶段中的任何一个中,可以添加来自水系数的附加数据或者其它生理或生化值,以提高该技术的实用性。 In any of these stages, you can add additional data from the coefficient of water or other physiological or biochemical parameters, in order to improve the usefulness of the technique. 例如,在给定的图像中可以选择不同的色彩方案来表示OxyHb、 DeoxyHb和水系数,或者对于一个像素或者区域的每一个系数的标量值可以被表示为XX//YY〃ZZ。 For example, in a given image, you can select a different color scheme to represent OxyHb, DeoxyHb and water coefficient or coefficients for each pixel or region of scalar values can be represented as XX // YY〃ZZ. 例如,在目标区域从皮肤确定的OxyHb系数均值在休克开始之前下降,同时该值的标准差增大。 For example, in the target area determined from the skin before OxyHb mean coefficient of shock began to decline, while the standard deviation values increase. 这些趋势在人LBNP和猪出血实验中都观察到了。 These trends in human and pig bleeding LBNP experiments are observed. 此外,超光谱休克指数(其由OxyHb系数的均值和标准差获得), 斑点指数以及时域指数被表明与心率和低体负压相关,并且与心搏量和脉压适度相关。 In addition, hyperspectral shock index (which is obtained from the mean and standard deviation OxyHb coefficient), and the spot index related time-domain index is indicated and the lower body negative pressure and heart rate, and moderately correlated with stroke volume and pulse pressure. 利用糖尿病作为实例,OxyHb/DeoxyHb值通常对于对照受试者为约30/40,对于患有糖尿病性神经病的受试者为20/50。 As an example the use of diabetes, OxyHb / DeoxyHb value is usually subject to the control is about 30/40, for a subject with diabetic neuropathy is 20/50. 麻醉可以改变对于皮肤血流的控制机制,导致血流振荡(通常响应于血容量过低而发生)的抑制。 Anesthesia can change the skin blood flow control mechanisms, leading to blood flow oscillations (usually occurs in response to hypovolemia) suppressed. 超光谱图像对于麻醉病人和苏醒病人可以是不同的,可以随着麻醉的深度而变化,或者可以随着施予的特定药物而变化。 Hyperspectral image for anesthesia in awake patients and may be different, can vary with depth of anesthesia, or following administration of a particular drug can vary. 在各种药理情况下的反应文库可以用于改善结果。 Library in a variety of pharmacological reaction conditions can be used to improve the results. 例如,Freeman等人的美国专利6,640,130教导了通过多变量分类算法从包括热测量在内的多个图像和谱图提取信息的用途。 For example, Freeman et al., U.S. Patent No. 6,640,130 teaches the use of extracting information from multivariate classification algorithms including thermal measurements, including multiple images and spectra. 添加关于病人状况、其它血液动力学或者其它参数、推定诊断或者施予的治疗的信息可以改善结果。 Add on the patient's condition, other hemodynamic or other parameters, presumptive diagnosis or treatment administered information can improve the results. Braverman 和其同事通过激光多普勒血流测定法(laser D叩pler flowmetry)描述了皮肤循环显微解剖学和血流的区域不均匀性之间的关系。 Braverman and colleagues (laser D knock pler flowmetry) describes the relationship between the skin and blood circulation Microanatomic regional variation between the assay by laser Doppler. 他们还描述了在身体同侧和身体异侧的肢上的位置之间的血流振荡的同步性,提示这样的振荡主要由交感神经系统控制。 They also describe the position on the ipsilateral limb and the opposite side of the body between the blood flow oscillations synchronization, prompted mainly by the oscillation so sympathetic nervous system control. 在低体负压下的未麻醉人中采用MHSI的进一步研究表明,图像的目标区域(ROI)中的区域不均匀性的增大可以由氧合血红素和氧饱和度(SHSI02)的超光谱测量来表明,并且氧合血红素和S服02的这样的不均匀性的变化是对于中心血容量过低的反应的主要特征,因为在不同的时间点所收集的图像之间不均匀性变化更大。 Further research unanesthetized humans at low body negative pressure using MHSI showed an increase in non-uniformity of the image of the target area (ROI) in the area may consist of oxyhemoglobin and oxygen saturation (SHSI02) hyperspectral measurements show that such variations and unevenness of hemoglobin oxygenation and S 02 is the main service center for the characteristic reactions of hypovolemia, since unevenness varies between different time points in the collected image greater. 热调节是皮肤循环的主要功能,并且在外伤伤员中通常出现体温下降。 Thermal regulation loop is the main function of the skin, and usually occurs in injured trauma hypothermia. 同样现在对于用于帮助患有血液动力学不足和其它医学问题的病人的早期护理的治疗还处于发展阶段。 The same dynamics are now suffering from the lack of blood to help patients and other medical problems early care therapy is still in the development stage. 通过MHSI技术可以定义全身体温下降和局部皮肤总血红素、氧输送、氧提取以及氧饱和度之间的关系。 You can define the relationship between the body temperature drops and topical skin total hemoglobin, oxygen delivery, oxygen extraction and oxygen saturation between technology through MHSI. 在出血性休克研究过程中,平均皮肤氧饱和度(SHs,02)和OxyHb值的下降不是由全身体温下降引起的。 In hemorrhagic shock during the study, the average skin oxygen saturation (SHs, 02) and OxyHb values fall not by the body temperature drops caused. 核心和皮肤温度被维持。 Core and skin temperature is maintained. 在单独的实验研究中,中度的体温下降(降到32C)不会产生与在出血性休克中观察到的相同的ROI上的组织氧合的平均变化。 In a separate experiment study, moderate hypothermia (reduced to 32 C) does not produce the same average ROI and organizational change observed in hemorrhagic shock on oxygenation. 随着更深程度的体温下降(26C),观察到更明显的变化。 With the greater degree of hypothermia (26 C), is observed more significant changes. 可能地,在体温下降期间, 减小的代谢要求抵抗了减饱和作用。 Possibly, during the temperature drops, reducing the metabolic demands resisted desaturation effect. 这些实验在麻醉的猪中进行,并且苏醒或者麻醉的人可能具有非常不同的结果。 These experiments in pigs were anesthetized and awake or anesthetized people may have very different results. 在这些情况下,得到了将可用于在发生或者导致了体温下降的情况下监测生理状态的不同参数和模式。 In these cases, has been monitoring the case temperature drops below the physiological state of different parameters and modes will be available in the event or led. MHSI可用于监测与体温下降的全身生理学和代谢状态。 MHSI can be used to monitor the temperature drops and systemic physiology and metabolism. 传统地,医师已经利用毛细血管再充盈作为全身灌注的指示。 Traditionally, physicians have used capillary refill as an indication of systemic perfusion. 若干其它的专利描述了同样试图提供休克的早期检测的方法。 Several other patents describe a similar attempt to provide a method for early detection of shock. Shani等(美国专利申请公布No. 20040249290)描述了一种休克监测设备,其由记录病人的皮肤变化的光学设备构成。 Shani et al. (U.S. Patent Application Publication No. 20040249290) describes a shock monitoring device, which consists of an optical recording apparatus constituting the patient's skin changes. 在该专利中,如同医师按压皮肤一样,压力被短暂地施加在病人的外周皮肤上。 In this patent, as doctors pressed skin, pressure is briefly applied to the outer periphery of the patient's skin. 该设备自动检测皮肤从白变回到粉红色所需的时间,提供毛细血管再充盈时间的量度。 The device automatically detects the skin from white to pink back to the time needed to provide a measure of capillary refill time. 如上所述,血压测量被最常用于确定与休克相关的血压过低。 As described above, blood pressure measurements are most commonly used to determine the shock associated with hypotension. 若干最近的专利描述了几种利用血压测量来监测休克的额外方法。 Several recent patent describes several additional methods to monitor the use of blood pressure measurement of shock. Sharrock等(美国专利申请公布No. 20030040675)描述了用于监测心血管系统的非侵入式方法。 Sharrock et al. (US Patent Application Publication No. 20030040675) describes a non-invasive method for monitoring the cardiovascular system. 在该方法中,压强传感器被布置在血压箍带下方。 In this method, the pressure sensor is arranged in the bottom of the blood pressure cuff. 进行"超心脏收縮(Suprasystolic)"测量,即,在箍带压强大于病人的心脏收縮血压时进行压强测量。 A "super-systolic (Suprasystolic)" measurement, i.e., when the cuff pressure is greater than the patient's systolic blood pressure pressure measurement. 所记录的时间序列示出了由心跳产生的初始脉搏,接着是一系列来自循环系统内的反应。 The recorded time series shows the initial pulse generated by the heart, followed by a series of reactions from within the circulatory system. 该专利描述了根据血液时间序列估计血管收縮程度的方法。 This patent depicts a blood vessel contraction time sequence estimation method. 所描述的数据表明超心脏收縮可以有助于休克诊断。 Data show that ultra-described shock may help diagnose cardiac contraction. Cohen等(美国专利申请公布No. 2004015816)描述了血压测量的第二用途。 Cohen et al. (U.S. Patent Application Publication No. 2004015816) describes the use of a second blood pressure measurement. 在该方法中,通过估计循环树(circulary tree)的总机械阻力,可以由血压测量来计算出与心脏输出量成比例的量。 In this method, by estimating the loop tree (circulary tree) total mechanical resistance, it can be calculated from the measured blood pressure and cardiac output is proportional to the amount.如上所述,心脏输出量显然是确认休克开始的重要参数。但是,因为该设备估计与心脏输出量成比例的量(而不是直接估计心脏输出量),所以在该设备可以被用于检测休克开始之前,其将需要对于每个病人进行基线测量。此外,由心脏输出量测量产生的数值本身不总是与不可逆的血压动力学紊乱相关,即,给定个体的反应或者适应性存在不同一这用由MHSI可获得的多参数更容易定量和监测。类似地,在诸如糖尿病或者充血性心力衰竭的更慢性的病症中,可以监测氧输送和提取的微循环改变和变化,并且可以提供疾病状态或者疾病进程的有用信息。并且,可以将给定个体的与休克相关的数据与反映糖尿病、充血性衰竭或者影响微循环或者皮肤的其它疾病状态的给定基线相关。随着糖尿病的影响范围增大,对于急性休克在慢性糖尿病的基线上的表现形式的理解是在必要的。类似地,充血性心力衰竭是一种慢性病症, 但是是其中对心原性的、出血性的、败血性或者其它休克的评估可能是特别重要的病症。同样,利用充血性心力衰竭参数库的基线,可以更容易地解释在休克中在这样的病人中观察到的特征的重要性。该方法基于超光谱成像应用,在Freeman等的更早的专利——美国专利号20040236229中有描述,该专利通过引用被全文包含在本文中。对于上述方法的评价是其在许多情况下可以与MHSI测量互补。例如,由血压得到的估计可以提供关于整个循环系统的信息,而MHSI测量提供示出了皮肤中的循环模式的局部变化的高分辨率图像。 MHSI是一种"成像光谱法"的方法。光谱法被广泛用于监测各种组织的代谢状况。例如,光谱法被结合在上述的脉搏血压计中,其利用不同的氧合血红素和脱氧血红素吸收带来估计动脉氧饱和度。在近红外区域中的点光谱法提供关于皮下组织、肌肉和/或脑中的氧的组织饱和度以及组织水合的情况,并且已经被用于出血性休克、手足筋膜间室综合征的疾病监测,以及用于跟踪头外伤。近红外测量已经被用于提供对血氧合的测量,其有可能用于检测休克。 Ward等的最近的专利(美国专利申请公布No. 20040039269)描述了使用紫外、近紫外和近红外共振Raman光谱和荧光光谱来用于组织检查的休克监测方法。除了别的内容之外,该发明还教导了可见和NIR漫射光谱法用于休克检测的用途,其不需要如Ward等中所述收集弱的荧光和共振Raman信号所需的灵敏检测器。对于近红外(NIR)和相关的点光谱测量,这些光谱方法不会得到图像,因此不会传递对于预测身体对于休克的反应很重要的关于血流的空间分布或者微循环变化的任何信息。此外,血红素吸收信息在可见光区域要比在NIR强得多。假定常见的生物学和光学信号,由于更高的信噪比,更容易在可见光区域来定量与血红素相关的过程(如同在所提出的MHSI方法中所采用的)。 NIR光谱法已经被首先发展来监测更深的组织,诸如肌肉和脑。虽然皮肤和皮下测量结果可以被收集并且已经被报导,但是因为光极间距离和其它技术问题(可能包括与皮肤不均匀性相关的问题),这些结果是多变的,使得这些技术还没有被广泛用于临床实践。在机载系统(airborne system)中用于地质特征的分析数十年之后, HSI最近已经被应用于生物医学。对于某一区域的每一个像素获取反射光的光谱,并且对每一个这样的光谱进行标准光谱分析。这可以基于目标区域(ROI)的化学组成创建图像。这已经被用于组织学切片的显微研究。在体内,MHSI已经被局部地使用来显示在一氧化氮吸入和抑制后的缺血-再灌注模型中以及患有镰刀形红细胞疾病的病人中的皮肤氧饱和度的宏观分布。 MHSI的一个应用已经用于在整形手术之后的组织可存活性的早期预测:容易从在手术之后立即获取的近红外光谱图像所计算得到的氧饱和度映射图中明显显现出具有不足以维持存活的氧合的组织。相反,在手术后6 — 12小时,濒临坏死的临床信号对于肉眼来说不明显。烧伤后的组织可存活性的评估也已经被进行。关于微循环的MHSI信息己经被用于评估患有糖尿病的人中的区域和全身微循环变化,并且在反映区域(例如足背)和全身(例如前臂)组织氧合和Shs!02的MHSI数据与糖尿病足部疾病和发展溃疡的风险之间的相关性已经被找到。在对照受试者、糖尿病受试者以及具有神经病的糖尿病受试者中的SHs!02典型值为42%、 32%禾B 28% (Greenman et al. Lancet 2005; 366: 1711)。患有神经病的受试者发展足部溃疡的风险更高。神经功能对于控制微循环是重要的,这通过神经病性糖尿病患者中的血管舒张缺乏(这常见于在其它方面是健康的个体的受伤皮肤附近)得到证明。本文描述了MHSI的如下应用:评估全身性疾病,以满足对于在超光谱成像提供的深度水平在军事和民事领域执行对休克的实时或者接近实时评估和监测的设备和方法的迫切需求。如本文所实施和广泛描述的,本发明涉及如下的方法和设备,所述方法和设备用于通过超光谱或者多光谱成像实时地或者接近实时地评估一系列生理参数,包括到组织(包括皮肤、各种器官的黏膜或者绒膜)的氧输送和提取以及水输送,以及局部组织对于该输送的充分性的反应。本文描述的发明使用超光谱成像或者多光谱成像作为监测组织和微循环中(在此针对从皮肤获取图像进行了描述,但是不限于皮肤)的变化的非侵入式的并且(通常但不是必须的)非接触式的装置,其中,所述组织和微循环中的变化指示全身生理状态,包括在休克之前的状态或者在休克过程中出现的状态(不管是出血性的、血量减少性、心原性的、神经性的、败血性的还是其它休克状态)。微循环的变化还可以指示本文所述的其它生理状态或者紊乱,并且作为用于提供监测治疗或者再生和病人可存活性的充足性的指标的手段。与传统的方法不同,MHSI方法使用成像系统,并且能够显示和使人注意皮肤中的循环模式的变化以及这些变化中的变化。变化中的一种具体类型,色斑,已知是休克的症状。当对生理状态的评估,或者对于治疗的反应或者潜在反应的评估是有利的时,本发明可适用于军事、危重病护理以及慢性疾病处理领域,在这些领域中,存在与休克、糖尿病、感染、败血症、脱水、体温下降、组织缺氧、低重力环境、充血性心力衰竭、高血压、血压过低或者其它生理紊乱相关的微循环或者组织氧合变化。休克作为急性微循环病理学的实例代表了光谱的一端。糖尿病代表光谱的另一端,并且与更慢的更长期的变化相关,但是,这样的变化也被反映在微循环变化中。本发明的仪器和方法还可以被应用于许多形式的休克和其它急性和慢性病症,其中,用于筛査、评估、诊断、早期警告、治疗的监测或者可存活性评估的生理学监测是有用的。除了或者替代作为与对氧输送和氧提取的失配的局部反应相关的微循环变化和我们可以在出血性休克中观察到的水合变化,我们预期了其它与还可以通过超光谱成像确认、评估和定量的与其它形式的休克相关的具体发现结果。例如,在败血症休克中,多种炎性介导剂的存在影响微循环。这些微循环变化回过头来利用我们的MHSI 技术被确认并且监测。这允许关于感染或者休克的开始或者进展的具体信息,或者监测抗生剂、静脉内流体给药、用于治疗血压过低或者急性心脏代偿失调的血压增高剂(诸如多巴胺或者neosynepherine)或者其它治疗形式的功效。所观察到的微循环变化还可用于确定一种或多种致病生物, 这可能与异质组织信号相关。在其它慢性病症中,MHSI可以用于从组织获得空间和光谱数据,以提供与用于特定治疗的施予和监测这样的治疗的指示相关的信息。这包括使用MHSI测量来帮助医师治疗患有诸如高血压或者充血性心力衰竭的病症的病人,并且提供可以有助于与特定的抗高血压药的使用或者在减负剂之后相关的决定的有用信息。在此,可以针对特定的治疗方案来选择病人,或者可以利用MHSI来监测治疗。另外的用途包括在类固醇治疗方面监测天然组织或者受伤组织。另一个用途包括对于神经学缺陷的全身效应进行监测。另一个重申的应用是用于ICU和危重病护理目的的先进代谢监测器, 其用于定义代谢支持和组织氧输送和提取的充足性。这对于确定充氧和循环支持的组合充足性以优化护理和调节治疗是特别有用的。另一个用途是用于评估充氧的充足性。在患有肺损伤的病人中,有时过充氧或者过氧合可能导致组织损伤并且延长住院时间,或者甚至导致差的长期后果或者死亡,确定维持充足的组织氧合和吸氧所真正需要的呼吸器支持的最小量将是有用的。这可以通过如下方式来确定:监测从对组织氧合血红素、组织脱氧血红素的测量获得的氧输送和氧提取水平,和/或利用由这两种测量提供的信息,同时添加或者不添加关于被监测组织(例如,皮肤、黏膜或者其它组织)的水含量的信息。这还可用于确定对肺部药物(包括气管扩张剂、表面活性剂等)的需要。受到生物或者化学剂的作用的病人的超光谱成像允许由非专业人员简单实施,用于野外、诊所和医院环境下的快速使用,而不必进行事先的病人准备或者随后的实验室工作。在一个实施例中,利用生物相关化合物的光谱和空间数据,使用MHSI确定生理变化,以估计与零星感染或者流行性感染相关的个体或者人群的感染。在这些环境中,MHSI为治疗类选法、筛查、诊断、确定疗法、治疗监测、监测疾病进程或者分辨提供了有用的工具。对于可能受到生化战(CBW)药剂的作用的情况,MHSI确定可能的起作用的病原体/种类,并且估计作用程度,疾病进程和治疗的有效性。在病原体种类之间的进行区分的快速、低成本、非侵入性筛查工具允许评估在流行病期间人群的关键部分。具体地,MHSI可以利用氧合血红素和脱氧血红素以及水数据图像的组合估计各种免疫法(例如天花)的"反应",以便于诊断。在某种程度上,所有病原体导致微循环变化,并且身体本身充当"生物放大器",因为其产生包括局部化或者扩散化的皮肤表现的免疫反应。这些检查这些反应本身,以检测指示受到生物剂作用的细微变化。生物剂对于作为整体的有机体的特性影响可以是较显著的,并且产生较大的检测"信号",这与现场确定少量小的细菌或者病毒的更困难的任务不同。通过放大此自然反应, 在一个实施例中,MHSI可用作评估在自然流行病中或者生物战争场景中有感染危险的人的筛査工具。除了CBW应用,超光谱技术更广泛地提供了在感染环境下将局部信息与全身病原生理学相关联的能力。对于感染的快速和准确的判定和分类将有利于从由于HIV或者化疗而免疫受损的病人到败血性休克的老年或者非常年轻的病人的范围内的广大病人。通过区分传染性有机体的种类, MHSI可以有助于确定抗生治疗方案的最初选择,或者有助于在病毒性肠胃炎和阑尾炎之间进行诊断。在另一个重申的应用中,MHSI被设计来评估不那么显著的代谢变化,以及诸如糖尿病之类的慢性病的后遗症。糖尿病人具有动脉粥样硬化的外周脉管疾病或者糖尿病性足部溃疡继发的肢体丧失的高风险性,并且将大大地受益于从能够在早期阶段检测感染的扩散或者全身性后遗症的设备。在受化学或者生物作用方面,MHSI可以用于快速和准确地评估受伤或者受影响的个体的血液动力学状态。 OxyHb、 DeoxyHb和H20或者这些参数的任何组合的局部变化可以用于评估可能受到化学或者生物剂作用的受害人的生理状态。给定具体的与免疫或者炎症相关的变化,心血管或者神经或者其它反应、作用的严重程度、毒剂的确认、作用的持续时间、反应的严重性和对于护理者有用的其它参数可以被评估并且随时间来跟踪。 MHSI可以提供获取可用于评估病人状况的"生命征候(vital sign)"的非接触式手段,无需接触病人或者去除任何防护装备。笨重的生化战(CBW) 个人防护装备可能妨碍医务人员或者急救者进行对同样也可能穿着CBW 装备的伤员的标准评估所需的接触。获取脉搏或者测量血压经常是不可能的。与可能受污染的个体接触的任何装置也可能被污染,并且在没有繁重的清洁措施或者一次性遮盖物的情况下可能不能被再利用。因此,作为远程感测技术以在这样的环境中提供生理和血液动力学评估的MHSI的使用是非常有利的。并且,优选的是如下的感测技术,其将透过CBW装备的若干部分(诸如透明塑料面板或者其它这样的装备中的窗口),或者直接透过不透明的织物或者其它这样的材料进行观察。在一个实施例中,所提出的发明可以通过向受到生化防护服的战地医务人员提供报告危重伤员信息的"生命征候",来提供外伤治疗类选法。所得到的用于传送可以被解释为新的"生命征候"测量的信息的MHSI算法将固有地确定为了提供最有效的伤员护理和远程治疗类选法所需的测量。本发明还为医务人员提供更大的作出决定的能力,以基于否则的话是不可得的关于生存/死亡状态、受伤的严重程度和进程以及哪些伤员需要生命救护介入的信息,对伤员护理进行优先次序排列。在一个实施例中,由战地医务人员携带的个人数字助理(PDA)之类的设备可以具有单个按钮,该按钮甚至可以在戴有防护手套的情况下被按压,以获取HSI图像并且提供数字读数或者甚至更简单提供倒下的士兵的医疗状态的简单可视码(绿、黄、红)。 MHSI通过允许穿着CBW装备的战地医务人员能够:1)在士兵受伤后的短时间内开始治疗类选法;2) 接收更准确的关于受伤严重程度和朝向休克的进程的信息;以及3)优化可用的治疗和疏散,来减小战争的伤亡。最后,因为战地医务人员(即使不存在CBW的担心)的战争期间死亡率高达步兵的两倍,所以HSI可以通过提供对于死亡或者不可抢救的士兵的早期确认,尤其是在生化战争情况下通过允许非接触并且更远程的测量,有助于减小战地医务人员的风险。在一个优选实施例中,MHSI被用于提供手持、耐用并且可随时使用的系统,该系统用于基于空间和光谱数据的组合提供接近实时的信息。在被设计为用作外延工具的情况下,此实施例只要求最小的操作者技能,并且该设备可由穿着CBW服装的终端用户操作。优化地,战场或者CBW 毒剂检测设备将提供来自具有远程或者本地光源的远距离的信息,但是至少,较之需要个体接触的评估,甚至数英寸的操作距离也将具有明显的优势。对于暴露的手或者透过标准气体面罩的对于眼/颊区域的监测可以提供生理评估所需的表面。超光谱成像可被用作外延工具,作为非接触式生命征候监测器(例如,非接触式诊断或者生命征候),由穿着CBW防护服的供给者在各种距离和在由于CBW防护服而难以接触受害者的情况下预测代谢阻碍和濒临的血液动力学虚脱。在一个优选实施例中,MHSI提供如所述局部化的空间和光谱数据, 用于判断伴随麻醉的血管舒张,以及血管收縮剂(诸如neosynepherine)的可能使用(以抵消全身麻醉或者区域麻醉(例如脊柱)对于全身或者下部身体脉管系统的影响)。在另一优选实施例中,所提出的发明的一部分通过非收縮性的臂带或者其它固定设备附接到身体上,以使其稳定并且便于随时间获得多个读数。图像数据或者计算结果可以通过电线或者以电子方式发送到远距离的监视器。另一个实施例可以提供将成像仪靠近或者轻微接触组织地固定, 以从皮肤或者从口腔、直肠或者膀胱黏膜或者其它组织获得图像数据的方法。在一个实施例中,优选地,利用具体的诊断方案,所提出的发明可以评估在肺栓塞之后肺和循环功能的充足性。在另一个实施例中,优选地,利用具体的诊断方案,所提出的发明可以在帮助确定低血球密度为满足终端器官组织(诸如皮肤)的代谢需要的充足性过程中,帮助评价和管理慢性贫血症、白血病或者其它癌症。在另一个实施例中,优选地,利用具体的诊断方案,所提出的发明可以帮助评价和管理化疗剂和其副作用。在另一个实施例中,优选地,利用具体的诊断方案,所提出的发明可以帮助管理或评价在心脏或者肾脏移植之后器官排异的全身性表现。在一个实施例中,在给定一氧化碳的独特光谱信号的情况下,MHSI 被设计来评估和报告一氧化碳水平,以用于诊断和监测可能受到或者真正受到一氧化碳作用之后的病人,并且帮助确定一氧化碳的组织水平并且监测和调节治疗。所提出的发明的一个实施例被设计用于具有循环或者呼吸障碍之一或两者的外伤或者烧伤病人的筛査、诊断、评价和监测。所提出的发明的一个实施例被设计用于监测患有发烧或者感染的病人。在给定具有微循环后果的发炎和影响血管的反应的情况下,MHSI被用于监测对于各种有机体的普通反应或者由于化疗或者内在疾病(例如AIDS)而被抑制免疫的病人的反应。所提出的发明的一个实施例被设计用于确认对输血的需要以及红细胞量或者血液体积已经被充分地补偿的时间。因为其能够测量血红素和血红素分解产物,所以所提出的发明可用于评价新的血液替代产品并且用于监测其在临床环境中的用途。这可以涉及如下范围:从确定循环血液中氧携带能力的充足性到利用MHSI光谱和空间特征对替代品从毛吸血管或者小脉管的潜在溢出进行跟踪。所提出的发明的一个实施例被设计用于确定是否向低血压病人提供并且提供何种(例如血液或者类晶体)对抗血压增高药,诸如肾上腺素。所提出的发明的一个实施例被设计用于在急性或者慢性高血压的情况下选择抗高血压治疗并且监测功效。所提出的本发明的一个实施例被设计用于药物研发或者作为研究工具针对临床试验选择或者评估病人,或者进行对组织微循环或者水合具有影响的任何药物或者备选药物的病人选择或监测。虽然我们主要关注了来自皮肤的读数,但是使用类似的仪器(具有特异于进行评价的组织和位置的不同前端光学器件和数据预处理),并且可以根据从其它位置,诸如颊、膀胱、直肠、食道、鼻咽或者其它黏膜、指甲床、耳垂、手掌或者脚底皮肤、或者内部器官的绒膜表面,获得的数据执行数据分析。获取合适的图像的成像系统和探针可以针对每一个位置进行特别地设计。这些测量可以间隔进行或连续进行,并且可以被记录用于静态测量或者用于趋势信息。通过揭示与不利的后果相关的组织水合、总血红素、氧输送、氧提取、S皿02或者循环模式的变化,MHSI方法还能够提供关于病人的可存活性、休克状态、生理、水合状况、补偿体积损耗的能力、休克类型、引起感染或者败血性休克的有机体或者有机体种类、以及治疗的功效或者充分性的信息。组织中的水含量也可用于这样的判定,并且被与总血红素、 氧输送、氧提取、S皿02或者循环模式或时域偏移数据相结合,或者被独立使用来传递关于休克的早期信息或者与其它有用的血液动力学参数相关的指标。数据和算法可以围绕如下三种类型的数据的每一个来建立:1)可见MHSI结合a)氧合和空间信息或b)氧合和脱氧以及空间信息或c) S服02与空间信息,d)对于氧合的平均变化,e)对S服02的平均变化; 2)红外MHSI数据结合作为ROI上的均值的大部分水和一些脱氧信息, 以及3) l和2的任意组合。一般来说,本发明使用成像系统来获取描述皮肤或者其它组织的一个区域的多维"超立方体"。这可以由帮助提供ROI上的光谱信息的许多波段或者至少2个波段组成。超立方体包含关于作为空间维度、波长和时间的函数的吸光度的信息。这些数据可以被处理,以产生对作为空间位置和时间的函数的化学物质的丰度的估计。出于休克监测的目的,血液氧合血红素和脱氧血红素的丰度图像是尤其有用的。这些丰度图像可以用于估计组织血液体积。在健康的年轻个体和在实验动物中,在不存在休克的情况下,在给定的ROI上皮肤氧合呈现为较均匀。在各种休克期间,可以单独或者同时发生数种反应,在本文中将更详细描述其中4种。第一种,可以观察到在组织中诸如OxyHb、 DeoxyHb和水的量的范围和总体水平的偏移。第二种, 可以观察到皮肤色斑。色斑血管收縮的结果,血管收縮导致OxyHb和DeoxyHb水平在皮肤上变得不均匀。具有较高和较低组织氧合的多个区域被观察到,得到了起色斑的外观。第三种,响应于脉管系统收縮的变化, 这些区域的位置可能随时间偏移(时域偏移)。第四种,响应于休克,出现新的循环模式,其中一些看起来与不好的后果相关。在老年和糖尿病病人中,存在更大程度的基线不均匀性,以及更低平均水平的OxyHb和本发明通过采用图像处理技术,利用了在上一段中所描述的反应,生成一系列衡量标准。这些在此描述的衡量标准包括图像中各水平的平均和分布,色斑的测量,以及皮肤随时间变化的快速程度的测量。这些衡量标准可以被单独使用或者组合使用,以得到提供对于休克的早期指示的指标。使用图像处理方法来突出被认为是病人可存活性的指示的循环特征。 HSI系统使用图像处理技术基于所得的化学浓度的分布曲线显示在ROI中呈现的梯度。也可以提供与给定的生理状态相关的所得的标量值。第一,描述了用于获取HSI数据、套准图像以及估计发色团的相对丰度的方法。第二,得到了用于处理图像以检测在超光谱方式得到的量中的总的、大范围的变化的算法。第三,得到了用于检测和估计皮肤的局部不均匀性(包括在可变大小的ROI内的分布)的图像处理算法。第四,得到了皮肤的色斑和图案化的特征。第五,得到了色斑图案随时间的变化。最后,描述了用于检测可以指示可能的病人后果或者休克反应的严重程度或者生理紊乱的图像中的特征的方法。因此,在五个处理处理步骤之前,描述了合适的HSI设备的一个实施例。医疗超光谱成像系统在一个实施例中,通过将HSI伪彩色图像与由相同的HSI数据合成的高质量彩色图片进行配对,以非常直观的形式提供HSI数据。通过在彩色和HSI图像之间进行翻转或者合并这些图像,容易实现对目标区域(ROI)的鉴定和估计,并且通过在ROI上进行放大以得到提高的分辨率和额外的信息,可以提高对目标区域(ROI)的鉴定和估计。图像可见于计算机屏幕、投影仪或者前导显示器(heads-up-display),和/或作为任何其它的数字信息被存储和传输,和/或被打印。所呈现的图像反映了超光谱成像仪的高分辨率,并且可以用升级的硬件进行改进。或者,数据可以以对于整个ROI、该ROI任意给定的像素或者选定的区域的单个标量数值的方式被提供。在此实施例中,优选地,氧输送和氧提取数据可以以XX/YY的形式被提供。类似于血压并且易于理解的,这样的测量承载了氧合血红素和脱氧血红素信息两者,但是较之单一标量变量提供了更完整的图片,因为两个分量的每一个都承载了特定的信息。如果水也被表示的话,则其可以被表示为XX/YY/ZZ。由于生物体系的复杂性,医疗人员希望获得关于给定情况的尽可能多的信息,以作出最可靠的诊断,但是需要将其简化到适用于帮助作出决定的形式。 MHSI向医生提供原先不可得的额外信息,并且可以与其它的临床评估一起使用,来作出决定。 MHSI提供由人进一步分析的图像;最初结果可以与査询表比较。最后,可以使用计算机算法,其自动将结果与从査询表所预期的后果进行匹配。此外,HSI将庞大的多光谱或者超光谱信息转录为一个图像,该图像通过代表梯度映射图中的精细梯度的数百万个彩色色调表示复杂的数据。在伪彩色图像中的特定颜色和不同形状的特征允许进行不同组织类型(诸如肿瘤、结缔组织、肌肉、溢出血液、以及血管)之间的区分。 MHSI还允许肿瘤级别的接近实时的区分,这对于作出适当的医学决定将是有用的。 MHSI的主要目的是以可容易解释的数值、图像或者其它的格式收集和提供生理相关数据,以便:1)将人的视力能力扩展到常规之外;2)通过预分析可观察的ROI的光谱特征扩展人脑能力;3)以实时或者接近实时的数据获取执行这些任务。算法的目标是帮助人类诊断和评估可观察受试者的状态。 MHSI是成功的,因为其利用反射电磁辐射(紫外-UV、可见光、近红外-NIR和红外-IR)承载较之视觉影像更多的信息,并且因为不同类型的组织反射、吸收和散射光的方式不同,所以超光谱立方体包含足够区分各种组织状态的信息。在此,局部组织状态被用来收集与个体或者有机体的全身状态或者生理相关的数据。 MHSI是耐用的,因为其基于光谱曲线的少数几个一般属性(例如,斜率、偏移量、OxyHb,、 DeoxyHb、 和水);因此其就光谱覆盖率而言相对灵活,并且不敏感于特定的光波长。 MHSI是快速的,因为其使用快速图像处理技术,该技术允许在一个伪彩色图像中叠加吸收、散射(由斜率和偏移量得到)和氧合信息。图像立方体一般可以在1分钟内被收集,但是通常是在短的时间段内。图像处理技术的简单性允许以实时到接近实时的方式显示结果。 MHSI是可容易解释的,因为其可以传递如下图像,在该图像中,颜色的不同反映了不同物质的浓度的梯度映射图,这反映了不同的组织类型、代谢、生理状态或者病症。该区分是渐变的,而不是二元的。此外,结构的颜色和形状描绘了ROI中的组织的不同组成、生理或者代谢或者生存能力水平。根据本发明的实施例的便携式MHSI设备被描绘于图1中。便携式设备IO的重量小于IOO磅,优选小于25磅,更优选小于10磅。优选地,便携式设备可以是电池运行的,或者更优选地,可以具有适用于连接到现有电源的连接器。便携式设备IO包括光学获取系统36和诊断处理器38。光学获取系统36包括用于获取宽带数据、可见数据、紫外数据、红外数据、超光谱数据或其任意组合的装置。在优选的实施例中,光谱获取装置包括第一级成像光学器件40,光谱分离器42,第二级光学器件44,以及成像传感器46。可以存在一个或者多个子系统36a,例如单个子系统36可以围绕可见或者NIR LCTF进行构建。或者,可以有一个子系统36围绕可见光LCTF构建, 一个围绕NIRLCTF构建。可以存在如下的一个子系统36,其具有适用可见光和NIR波长两者的LCTF,或者可以存在一个子系统,现在我们需要用两个标号36分别用于可见光和NIR,但是在将来可以是组合的VIS/NIRLCTF。或者,光学获取装置可以是适于获取宽带数据、可见光数据、紫外数据、红外数据、超光谱数据或其任意组合的任何获取系统。优选地, 一个或者多个偏光器41、 43被包括在获取系统中,以在光进入到成像传感器之前将其编入偏振平面。网络执行管理器(NEM) 明。在粥描述.事实匕是软件悃的NEM的结构。该巾涩的角色是代表所述远程设备210在所述服务器214、216启动任何远程执行。下列任知通过NEM来执行: (1)作为通信控制器来连接所述远程设备210和月良务器214、216。 (2)在所述远程设备210和月良务器214、216之间翻酗递枞。 (3)处理网络异常。 (4)为多重服务器管理j9艮务器II)。 (5)缓冲所述请求来最小化网络拥塞。 (6)作为防火墙以防止非法访问。图18示出了所述NEM的基本结构。其具有处理来自所述D OEM 的命令的命冷啦制器。仂议翻译器管理从个网络到另—个网. br络id韵ge302 300 304数据和命令的翻译。例如,所述智能卡使用IS07816-4格式。在向网络发送请求以前,所述协议应该针对互联网连接而从IS07816被翻译到TCP/IP。服务器管理器306管理所述服务器的连接和所述服务器ID。网络控制器308管理到网络的连接。其具有用于最小化网络拥塞的本地网络缓冲器。防火墙310被用来防止任何非法连接。另外,网络异常控制器312被用来应付任何网络错误,并将所发生的任何网络异常直接报告给所述命令控制器300。分布式对象执行管理器(D.OEM) D-OEM管理用于远程设备210的远程拙行请求。该远程设备210发送负载分担请求给本地客户机朋艮务器。如果所述客户计算机212可以处理该对射函数,则D. OEM client将通过所述执行管理器本地执行该函数。否则,所述D—OEM_bridge将该请求传送给所述眼务器214、216,并在该服务器214、216端实觋擞行。图19示出了D-OEM的基苓结构。该D. OEM具有内核414,该内核具有单独的入口点。其具有访问D. OEM对象内的全部资源的特机该D. OEM具有对象构造器416,以初始化该对象内部的所有组件。命令编码器和解码器418同步上述D-OEM命令。网络接口420是软件接口,其与夕挪的网络对象绑定以与外界部分建立通信。同步管理器422管理全部同步请求。异常处理器424管理如果光谱分离器42不在内部使光起偏,则第一偏光器43被布置在光路中的任何地方,优选在接收摄像机46前面。第二偏光器41被布置在照明光(20)的前面,使得入射光偏振被控制。入射光与由摄像机46记录的光正交偏振,以减小镜反射,或者以一定角度偏振,以改变由摄像机记录的反射光的强度。照明由一束或多束远程光(20)提供,其优选围绕系统的光接收开口布置。光可以是聚焦LED光的一个或多个环形阵列,其发射具有用于处理算法的特定波长(或者波长范围)的光或者处于一定波长范围(例如,可见和/或近红外)的光。处于围绕光接收开口的一个或者多个环的形式的环形或者基本环形布置的光源提供均匀照明,减小了阴影。光波长的选择性减小了到皮肤上的总的辐射,因此减小了该观察对于观察对象的影响。特别是在红外区域,这可以导致对皮肤的热效应的减小,并且将组织维持在更正常的状态。虽然优选实施例将系统描述为便携式的,但是也可以使用非便携式的系统。优选地,光学头被安装到检査室的壁上。在另一个实施例中,系统具有带有俯瞰操作位置的观察窗的便携台。第一级成像光学器件接收通过偏光器从组织样品收集的光,并且将光聚焦到光谱分离器的表面上。优选地,光谱分离器是液晶可调滤波器(LCTF) 。 LCTF42是可编程滤波器,其从与从样品收集的光具有小(例如,7—10nm)的带宽的选定波长带按顺序地提供光。第二级光学器件44 接收通过光谱分离器的窄带的光,并且将光聚焦到图像传感器46上。图像传感器优选(但不必是)二维阵列传感器,诸如电荷耦合器件阵列(CCD)或者互补金属氧化物半导体(CMOS)检测器,其将图像信号传输到诊断处理器38。诊断处理器38包括图像获取接口50,其具有响应于图像传感器46的输出的输入以及提供给通用操作模块54的输出。通用操作模块包括执行图像处理并且操作和控制系统的各个部分的例程。通用操作模块还控制一个或多个光源(例如LED阵列),以允许其按照算法的要求在测量过程中接通和关断。通用操作模块具有提供给滤波器控制接口52的控制输出,滤波器控制接口52接着具有提供给光谱分离器42的输出。通用操作模块还与一个或者多个诊断方案模块56A、 56B、 ...56N交互,并且具有提供给视频显示器的输出。诊断处理器包括专用硬件,具有专用软件的通用硬件,或者两者的组合。诊断处理器还包括输入设备58,其可操作地连接到通用操作模块。存储设备60和打印机62也被可操作地连接到通用操作模块。在操作中,使用便携式或者半便携式设备靠近目标,例如,手前臂或者感兴趣的其它一般区域。操作者通过使用输入设备选择诊断方案模块开始操作。每一个诊断方案模块适用于检测目标的特定组织特性。在可选实施例中,设备可以只包含一个适用于通用医疗诊断的诊断模块。诊断处理器38通过从选定的诊断方案模块56获得一系列的转移功能和图像处理方案,来响应操作者的输入。诊断处理器经由其滤波控制接口52向光谱分离器42提供滤波转移功能,然后命令图像获取接口50获取和存储来自图像传感器46的所得的经滤波的图像。根据存储在选定诊断方案模块中的滤波转移功能的数量,通用操作模块54将这些滤波和获取步骤重复一次或者多次。滤波转移功能可以代表带通、多带通或者其它滤波特性,并且可以包括优选处于UV、优选可见光、优选NIR和优选IR电磁谱中的波长。在优选实施例中,向ROI传输光的光源可以与对由检测器收集的返回光进行的滤波或者选择相对地被滤波、选择或者分离。因此,可调谐源传输该信息。或者,可以使用可调谐源和可调谐检测器两者。这样的调谐采用LCTF、声光可调谐滤波器(AOTF)、滤波轮、匹配滤波器、衍射光栅或者其它光谱分离器的形式。光源可以是纤维光学器件,但是优选是发光二极管(LED)(参见K. Gono等,"Appearance of enhanced tissue features in narrow-band endoscope imaging" Journal of Biomedical Optics, 9(3):568-77, 2004;其通过引用被明确地包含于此)。该用途是非常新颖的,并且是基于不仅仅使用LED作为一宽泛性的光源,而是特意地选择LED来以使得不再需要波长选择器的方式提供特异于目标发色团的照明。 LED和其它系统参数可以被选择,以提供关于在由设备所测量的波长下具有适当的光谱特性的化合物,而无论设备是作为医疗设备还是作为用于其它应用(诸如环境、食品工艺控制、药品工艺控制、地质、军事等)的设备。在一个实施例中,这样的设备将特别适用于在内诊镜(更优选地,一次性内诊镜或者其它其中低成本、近光源(与具有光纤传输系统的远距离源相反)将是有利的设备)的终端使用。所提出的仪器可以用作远程设备的一部分,所述远程设备用于内诊镜、腹腔镜、内孔窥视镜或者其它用于身体的、或者诸如工业管线的任何结构内表面的、或者机器内难以到达的位置的内部检査的刚性或者柔性设备,以扩增可用的诊断或者其它数据。在内诊镜、腹腔镜、内孔窥视镜或者其它用于身体的、或者诸如工业管线的任何结构内表面的、或者机器内难以到达的位置的内部检査的刚性或者柔性设备的情况下,所述的LED系统可以被布置在观测仪器的操作者一端,并且通过光纤器件发送到终端。或者,小的LED可以被布置在观测仪器的终端,用于直接照明ROI。在医疗应用中,这样的观测仪器可以被用于评估全身休克(类似于在此描述的皮肤读数),或者诸如缺血性大肠炎的区域缺血或者诸如癌症或息肉的局部疾病。 HSI图像回到组织上的投影有利于诊断和靶向活组织检查。在另一实施例中,HSI仪器可以被布置在用于远程感测的机械人上。在另一个应用中,透镜可以被配置来收集来自远距离的数据。具有长距离穿透性的LED、激光器或者其它照明源,或者诸如太阳光的环境光可以被用于照明目标。这些中的任何一种可以被独立使用,或者不同的几种类型可以被组合使用,以在数据收集过程中输送所用的全光。在这样的优选实施例中,HSI仪器被用作非接触式远程装置,用于在血容量过低引起的低体负压过程中模拟极端环境条件下的生理状况。优选地,由穿着生化战(CBW)防护服的非技术供给者监测生命征候,以防止代谢障碍和濒临血液动力学虚脱。这样的系统在CBW中是有利的。可以从人的皮肤或者目标的表面通过对于所用的波长透明或者部分透明的任何物质收集光。该方案的一个实施例可以用于透过防护面罩进行病人评估,所述面罩用于提供免受可能有害的化学或者生物剂的影响的保护。在另一个实施例中,用LED系统或者其它(基于,基于滤波器的)系统,与反射光相反的透射光将通过较薄的组织(例如手指或者脚趾或者耳垂或者颊之间的网络空间)被收集。在另一个实施例中,半透明、透明或者半透光的膜或者其它物质可以被放置在皮肤上,以对照明和反射两者进行滤光。在另一个实施例中,在光源来自或者是固有的或者是与注射或施加荧光体或者磷光体相关的组织化学发光、磷光、或者荧光的情况下,该系统和方法可以被用于或者适用于记录来自皮肤和其它组织的信息。这样的发光化合物可以是静态的,或者基于现存条件是动态的,其随温度、湿度、 压强变化。这将允许更深组织的更好的空间分辨率。在另一个实施例中, 可以注射或者施加光的特定吸收剂(诸如,靛青绿、纳米粒子)或者反射剂(诸如英脱利匹特(intralipid)或者微球)。由LED提供的独特的冷照明防止了可能导致差的图像分辨率的对皮肤和其它组织的过度加热。优选地,LED提供足够的光,同时产生最小的或者不产生或产生小的可知的皮肤或者组织温度的上升。此光照系统与偏光器组合允许充足的照明,同时防止了从内部器官的表面闪光以及对被检査的皮肤或者其它组织的过度加热。一旦图像获取接口50已经存储了由操作者选择的诊断方案所规定的所有图像平面的图像,则图像获取接口基于来自选定的诊断方案模块56N 的图像处理方案,开始处理这些图像平面。处理操作可以包括合成图像的一般图像处理,诸如比较在不同波长下的所收集的光的相对振幅,增加不同波长下的所收集的光的振幅,或者计算对应于所获取的平面的信号的其它组合。所计算出的图像被显示在显示器12上。其它优选实施例包括将所计算出的图像存储在存储设备60中,或者将所计算出的图像在打印机62上打印出来(参见美国专利No. 4,885,634;其通过引用被具体地包含于此)。在可选实施例中,诊断方案模块56、打印机62、显示器12或其任意组合可以被从便携式设备10上省略掉。在该实施例中,在医疗过程中, 所获取的图像被存储在存储设备60中。在稍后的时间,这些图像经由通信链接被转移到位于远程地点的第二设备或者计算机(例如医院医疗记录)上,用于备份或者在稍后的时间进行评阅。此第二设备可以具有被省略掉的诊断方案模块、打印机、显示器或其任意组合。在另一个实施例中,存储的图像从位于临床的便携式设备10经由通信链接被实时地转移到远程的第二设备。在一个实施例中,多个超光谱休克指标被呈现给操作者。这可以与也由该设备呈现的其它生命征候相关联,或者可以被呈现作为单独的测量结果。在可选实施例中,数据被简化成一组指令或者指示。例如,基于数据,设备可以仅仅针对健康示出绿光,针对需要复生治疗示出黄光,针对不可补救的生理紊乱示出红光。在优选的实施例中,系统经由前导显示器(HUD)或者经由投影将HSI数据与所呈现的数据的真实来源实时地或者接近实时地相关联。优选地,HSI将实时超光谱数据投影到目标区域或者视窗上。投影信息具有针对被照明的表面(例如,伤口、手术面、组织)的精确的一一映射关系, 并且以高效的方式提供必要的信息。当优选地投影到高悬视窗上时,图像(真彩色和/或伪彩色)可以被縮小/放大,以提供可变的放大倍数。此子系统由如下元件组成:1)图像投影仪,其视场与超光谱成像仪的视场精确对齐;2)小型远程控制设备,其允许操作者接通和/或关断投影图像而不用离开ROI,并且允许操作者改变所投影的图像上的突出结构和/或透明性,以提高感兴趣的特征的可视性以及所投影的图像的亮度和强度;3) 实时数据处理包,其基于超光谱数据和操作者/外科医生的输入,构建投影图像;4)任选的位于ROI上方的视窗,其对于真实观察是透明的,或者对于投影的伪彩色方案或者更高分辨率的图像是不透明的。为了实现超光谱图像和ROI之间的精确套准,系统根据需要执行自对准过程。系统使用投影仪将一系列校准图案投影在操作表面上,并且利用超光谱成像系统来读取它们。校准软件处理所获取的数据,并且存储它们。经处理的数据被投影系统进一步使用,以实现对于操作表面的高精度映射,并且对表面起伏进行补偿。这样的投影系统或者更简单的摄像机系统也可以被用于评价由局部外伤或者脉管损伤导致的局部组织损伤或者区域缺血(即,其中,腿是存活的,需要脉管再造,或者超出了股动脉损伤范围而不可挽救)的水平。区域或者局部脉管损伤可以紧接着由于休克、糖尿病、充血性心力衰竭等造成的全身性失常。投影仪可以用于确定切断手术的水平,或者帮助整形手术瓣再造的几何学。在另一个优选实施例中,如图2所示,超光谱系统由可见光和NIR光传感器(摄像机),调谐用于可见光和NIR波长的透镜,带有光控制器的照明器,以及运行系统控制、数据获取和预处理软件的计算机。照明器优选由一组或者多组具有不同发光光谱特性的LED组成。每一组具有其自己的中心发射波长和发射带宽。更优选地,每一组包括以围绕透镜的环形图案分布的LED,允许在每一个光谱点进行均匀照射。每一组LED由计算机控制的"照明器控制器"接通和关断。优选地,为了减小环境光的影响,测量两个图像之间的强度差。一个图像是在特定的LED组被接通时获取的,另一个图像是在该组被关断是获取的。另一个优选实施例包括两个本发明的设备, 一个具有窄带LED,另一个具有滤波器。测量序列的示例性实施例如下:接通第1组LED并且获取数据,关断该组LED并且获取数据;接通第2组LED并且获取数据,关断第2组LED并且获取数据;接通第3组LED并且获取数据,关断第3组LED并且获取数据,并根据需要继续下去。数据(目标的图像)在由每一组LED 依次进行照明的同时被获取。各LED组的中心发射波长和带宽被具体选择,使得如上所述获取的目标的图像的组合允许计算组织中氧合血红素和脱氧血红素的浓度以及水的浓度。 LED的优选中心发射波长和带宽按如下选择:<table>table see original document page 39</column></row> <table><table>table see original document page 40</column></row> <table>为了计算氧合血红素、脱氧血红素和总血红素浓度,使用根据第1-4 LED组记录的图像的线性组合和/或其比率。第2和4 LED组的强度以如下方式被调节:所得的发射光谱与氧合血红素的吸收光谱密切对应。第3 LED组的强度根据相似浓度的脱氧血红素的吸收光谱来调节。第l LED组的强度根据氧合和脱氧血红素光谱两者来调节。优选地,LED的强度根据特定光谱来内部地设定。优选的是,照明强度被调制来模拟DeoxyHb和OxyHb的光谱。变化范围可以从1到100nm 或者更大,但优选的变化从5到30nm,或者从10到60nm。持续或者暴露时间根据样品而变化。因此,对于每一个样品涉及有学习或者教导的方面。例如,皮肤样品的特性(包括但不限于毛发、色素和色调)使得获取适当信噪比水平的数据所需的暴露时间不同。对于从更深色的皮肤获得可接受的信号,暴露时间通常较之更白皙的皮肤更长。为了计算水的浓度和其随时间的变化,使用根据第5-6 LED组记录的图像的线性组合和/或其比率。第5和6 LED组的强度根据在与血红素相似浓度下的水的吸收光谱来调节。光源优选包括处于LED光前方的偏光器盘,其与覆盖透镜的中心盘正交偏振(或以一定的角度偏振)。但是,其它实施例可以不包括偏光器。在另一个实施例中,HSI系统使用液晶可调谐滤波器(LCTF),其被布置在标准透镜和数字摄像机的前方。通过改变LCTF两端的电压,来改变允许进入摄像机的光的波长。在图像获取过程中,产生多个图像(其每个处于独立波长下)的超立方体(优选在500到600nm上以5-20nm间隔)。然后,将超立方体中的每一个像素的可见光谱通过线性回归与氧合血红素(OxyHb)和脱氧血红素(DeoxyHb)的标准光谱进行比较。针对OxyHb 和DeoxyHb所得的拟合系数被用于计算ROI中的每一个像素的SHSI02 值。计算在该ROI上的OxyHb、 DeoxyHb和SHSI02的平均值。还生成ROI的灰度S服02图片,其中,每一个像素的亮度正比于其值。较之用于血红素光谱测量的近红外光谱法,可见HSI提供了提高的信噪比,因为血红素的吸收信号在可见光区要比在近红外区强得多。虽然NIR HSI信息中的大部分涉及组织中的水含量,但是也存在OxyHb和DeoxyHb信息。近红外点光谱的实用性已经显现于其提供关于表面下组织(例如在脑或者肌肉中)氧合的信息的能力(这得自近红外光的增大的组织穿透性)。相反,用于优选实施例的可见光光谱法,询査更浅表水平处(最可能的,在皮肤毛细血管内)的血红素饱和度。因此,利用得自可见连同近红外HSI的HSI信息或者得自可见HSI结合MR点光谱的HSI信息,提供了不同组织床的可能互补的信息,可见光报告更浅表的组织,而NIR报告更深的组织。比较来自特定位置的可见光和红外HSI数据可以传递关于休克或者区域或者局部组织生理学的有用信息。本发明的其它实施例在VIS和/或NIR测量的同时用IR温度计和IR热矩阵来记录表面温度。本发明的优选实施例和设备允许创建并唯一地确认突出感兴趣的信息的数据模式。在此情况下的数据组可以是离散图像,每一个被紧密结合在可以随后被分析的光谱中。这与通过各种彩色透镜看到的景象类似,其中,每一个彩色透镜除了特定颜色以外滤掉所有其它颜色,然后这些图像被重新组合成新的图像。诸如伪色彩分析的技术(其中,将不代表真实颜色而是人为指定的新颜色指派给图像,以改善由人进行的图像分析)也是适用的。可选地,光学器件可以被改进以提供縮放功能,或者可以从微观环境过渡到宏观环境,并且从宏观环境过渡到微观环境。此外,可以添加商业上可获取的元件,以提供实时或者接近实时功能。可以通过与两个或者更多个光学获取系统的三角测量,或者通过单个系统的旋转或者移动, 改善数据分析。可以根据需要使用偏光器,以改善针对各种目标的信号。除了具有收集数据的能力之外,本发明还包括将数据以各种方式组合的能力,包括视域融合、加法、减法和其他更复杂的处理,由此可以确定对于感兴趣的信息的某些独特的信号,使得背景数据和图像可以被去除, 由此突出了感兴趣的特征或者信息。这还可以与在信息的显示中标注或者突出感兴趣的条目、区域或者信息的自动方式相结合。在本发明中的超光谱解析的图像由多个光谱带组成。每一个光谱带与另一个相邻,形成连续的组。优选地,每一个光谱带具有小于50nm,更优选小于30 nm,更优选小于20 nm,更优选约20 - 40 nm,更优选约20 -30 nm,更优选约10 - 20 nm,更优选10 - 15 nm,以及更优选10 - 12 nm的带宽。对于本领域技术人员来说明显的是,根据本发明的医疗超光谱成像仪(MHSI)具有多种用途。 MHSI提供了如下优点,即,较之其它传统技术,可以更快速、更经济并且用更少的设备和基础设施/后勤支持完成用于所述用途的功能。对于其中医疗人员依赖其对生物系统的视觉分析的情况下,本领域技术人员通过本公开,可以确定许多类似的实例。 MHSI起到类似于"魔镜"的作用,用于帮助人们看到内部和远处。数据获取和数据预处理在本发明中的第一步骤是由所进行的测量创建超光谱数据组:获取超光谱数据立方体或者超立方体。病人的皮肤或者其它组织的一个区域被选择用于成像,并且在由不同波长范围的光照明(优选与在没有照明的情况的获取交替)的同时收集一系列的图像。优选地,所用的波长区域在450 到1200nm之间。在优选实施例中,所收集的波长包括在血液氧合血红素和血液脱氧血红素之间提供良好的区分的光谱的一部分,或者约500-600 nm。在另一个优选实施例中,系统还收集从水具有高的吸收性的光谱部分的波长,约950-1100nm,以及在血液氧合血红素和血液脱氧血红素之间提供良好的区分的光谱部分的波长,或者约500-600 nm。与每一个独立的波长带相关的"数据图像"被收集。利用记录摄像机,优选CCD或者CMOS摄像机将得自光谱区域的数据图像数字化,并且进行记录,形成三维"数据立方体"(2个空间维度和一个波长频率维度)。优选地, 一旦获取了全套的光谱数据图像,就以足够检测代谢状况的变化的频率重复进行扫描过程。有序的数据图像然后被收集在四维的"超立方体"(2个空间维度X1个波长频率维度以及l个时间维度)。优选地,在图像收集过程中,提供指定的活动照明。该照明的一个重要方面在于,其不应导致病人皮肤或者组织的明显加热。优选地,作为数网络执行管理器(NEM) 明。在粥描述.事实匕是软件悃的NEM的结构。该巾涩的角色是代表所述远程设备210在所述服务器214、216启动任何远程执行。下列任知通过NEM来执行: (1)作为通信控制器来连接所述远程设备210和月良务器214、216。 (2)在所述远程设备210和月良务器214、216之间翻酗递枞。 (3)处理网络异常。 (4)为多重服务器管理j9艮务器II)。 (5)缓冲所述请求来最小化网络拥塞。 (6)作为防火墙以防止非法访问。图18示出了所述NEM的基本结构。其具有处理来自所述D OEM 的命令的命冷啦制器。仂议翻译器管理从个网络到另—个网. br络id韵ge302 300 304数据和命令的翻译。例如,所述智能卡使用IS07816-4格式。在向网络发送请求以前,所述协议应该针对互联网连接而从IS07816被翻译到TCP/IP。服务器管理器306管理所述服务器的连接和所述服务器ID。网络控制器308管理到网络的连接。其具有用于最小化网络拥塞的本地网络缓冲器。防火墙310被用来防止任何非法连接。另外,网络异常控制器312被用来应付任何网络错误,并将所发生的任何网络异常直接报告给所述命令控制器300。分布式对象执行管理器(D.OEM) D-OEM管理用于远程设备210的远程拙行请求。该远程设备210发送负载分担请求给本地客户机朋艮务器。如果所述客户计算机212可以处理该对射函数,则D. OEM client将通过所述执行管理器本地执行该函数。否则,所述D—OEM_bridge将该请求传送给所述眼务器214、216,并在该服务器214、216端实觋擞行。图19示出了D-OEM的基苓结构。该D. OEM具有内核414,该内核具有单独的入口点。其具有访问D. OEM对象内的全部资源的特机该D. OEM具有对象构造器416,以初始化该对象内部的所有组件。命令编码器和解码器418同步上述D-OEM命令。网络接口420是软件接口,其与夕挪的网络对象绑定以与外界部分建立通信。同步管理器422管理全部同步请求。异常处理器424管理

据收集的一部分,获取固定到受试者皮肤的白反射器的图像。 It is part of the collection, get fixed to the skin of the subject image white reflector. 这提供了校准图像,其用于校准不均匀照明效应,并为计算吸光度提供参比。 This provides a calibration image, which is used to calibrate the uneven lighting effects, and provide a reference for the calculation of the absorbance. 在此描述的数据预处理优选由MHSI系统进行,并且更优选地,其是休克诊断模块的一部分。 Described herein is preferably made MHSI data preprocessing system, and more preferably, it is a part of the shock diagnostic module. 这样的模块在设备中可以自动的,或者可以由操作者从用于不同的应用的模块菜单中选择。 Such a module in the device that can be automated, or may be used by the operator from the different modules of the application menu, select. 优选地,全部与休克相关的不同的诊断模块还可以适当就位,由操作者在不同病人病症、环境条件或者其它环境下进行选择。 Preferably, all shock associated with different diagnostic modules may be appropriate position, selected by the operator in different patient conditions, environmental conditions, or other environment. 虽然不是必须的,但是优选地,实施以下预处理步骤中的任何一个, 并且更优选地,按所述地它们全部被实施。 Although not required, but preferably, the following embodiments in any pre-treatment step, and more preferably, they are all implemented by the ground. 优选地,数据预处理中的第一步骤是去除环境光贡献并且估计每单位时间的反射强度。 Preferably, the first step in data preprocessing is removed and the estimated contribution of ambient light reflection intensity per unit time. 这通过如下方式进行:对于每一个波长组,将在没有用LED或者其它操纵光的情况下记录的图像从利用了该光的情况下记录的图像减去。 This is achieved by the following manner: For each wavelength groups will be recorded in the absence of light with LED or other manipulation of images from the use of the case of the light image recorded minus. 所得的图像用暴露时间标准化,所述暴露时间优选对于两个图像(利用和没有利用操纵光)是相同的:HSI强度=利用了光的强度/暴露时间-没有用光的强度/暴露时间优选地,针对ROI或者ROI的一部分进行此步骤。 The resulting image is standardized with the exposure time, the exposure time is preferably for two images (with and not used to manipulate light) is the same: HSI intensity = intensity of light use / exposure time - no light intensity / exposure time is preferably to, or for the part of the ROI ROI to make this step. 更优选地,对于每一个像素或者多个像素组成的区域进行此步骤。 More preferably, for each of a plurality of pixels or pixel regions this step. 优选地,在弱的环境光条件下,作为替代进行对于暗噪音、读取噪音、环境辐射和相似失真源的校正。 Preferably, in the weak ambient light conditions, as a replacement for the dark noise, reads the correction noise, environmental radiation and similar distortion sources. 优选地,数据预处理中的第二步骤是将所得到的标准化的HSI图像强度对从白反射器记录的参比标准化的强度的比值以10为底取对数,来计算吸光度:吸光度=log1Q (HSI强度/校准强度) 对于每一个像素或者多个像素组成的区域进行该步骤。 Preferably, the data preprocessing second step is to record from the white reflector reference normalized intensity ratio of the resulting image intensity normalized HSI base 10 logarithm to calculate absorbance: absorbance = log1Q (HSI strength / intensity calibration) for each pixel or a plurality of pixels of the area of the step. 优选地,该校准强度在数据获取过程中和/或之前被记录并存储在HSI系统中用于随后的数据预处理。 Preferably, the calibration intensity during data acquisition and / or prior to being recorded and stored for subsequent data preprocessing in the HSI system. 优选地,数据预处理中的第三步骤是在每一个时间步长进行图像套准。 Preferably, the data preprocessing step is carried out in the third image registration at each time step. 套准使得在不同的时刻获取的图像平移、旋转并且縮放,使得在每一个时刻拍摄的图像中的区别特征在每一个图像中处于同一空间位置。 Registration so that the image translation acquired at different times, and scaling rotating, so that the difference between each feature in the image captured in a moment in the same spatial location in each image. 图像套准对于处于休克或者接近休克的病人尤其重要,因为病人可能由于疼痛和不舒服移动或者无意识地移动。 Image registration is especially important for patients in shock or near shock, because patients may move due to pain and discomfort or moving unintentionally. 如果需要,可以将校准器或者小的套准标记施加到皮肤上,以提供用于套准算法的区别特征。 If desired, the calibrator or a small registration mark is applied to the skin to provide a distinguishing feature for registration algorithm. 在Freeman等的美国专利申请20040236229和美国临时申请60/717,188中对图像套准问题有更详细讨论。 In Freeman et al, U.S. patent application 20040236229 and US Provisional Application No. 60 / 717,188 are discussed in more detail in the image registration problems. 一旦图像被拍摄并且预处理被完成,优选地,数据预处理中的下一个步骤是分解数据,以提供对于在图像的每一个像素中存在的化学信号的估计。 Once the image is captured and pretreatment is completed, preferably, data preprocessing next step is to break down data to provide for the chemical signals in each pixel of the image in the presence of an estimate. 除了超光谱数据之外,该分解步骤还需要对于每一个感兴趣的发色团(即,组织或者流体)的参比光谱。 In addition to the hyperspectral data, the decomposition step further need for an interest in each chromophore (ie, tissue or fluid) reference spectra. 例如,对于血液氧合血红素、血液脱氧血红素和水所拍摄的光谱可以用于该分解处理(参见图3)。 For example, for blood hemoglobin oxygenation, and blood deoxyhemoglobin spectra captured water can be used for this decomposition treatment (see Figure 3). 如果利用具有光分离器的系统(图1)记录超光谱数据,则超立方体中的每一个像素具有皮肤吸收光谱(一定程度上类似于图4中的光谱)。 If you use the system with optical splitter (Figure 1) record hyperspectral data, the hypercube each pixel having skin absorption spectrum (similar to Figure 4 spectrum to a certain extent). 然后,分解处理一般可以被设计为受约束的优化问题,其中,在受到丰度值的自然可能范围的约束下,估计每一种化学物质的相对丰度。 Then, the decomposition process can generally be designed to constrained optimization problems, which may range in by natural abundance of restraint, to estimate the relative abundance of each chemical substance. 但是,利用最小方差方案(对于每一个像素或者多个像素组成的区域)可以得到直接和大体地分解:<formula>formula see original document page 44</formula>分解得到对于所考虑的每一种化学物质的估计丰度的输出图像(在上述实例中,q和C2是氧合血红素和脱氧血红素浓度的图像,而C3是水的图像)。 However, using minimum variance program (for each pixel or a plurality of pixels of the region) can be obtained directly and substantially decomposed: <formula> formula see original document page 44 </ formula> decomposition for each of the considered chemical estimate the abundance of material output image (in the above example, q and C2 is the concentration of oxyhemoglobin and deoxyhemoglobin images and water images C3). 斜率和偏移分别由C4和Cs表示。 The slope and offset are represented by C4 and Cs. 在其中利用具有特别选定和/或经调制的光的系统(图2)记录超光谱数据的实施例中,利用来自每一个LED组的光来记录的数据图像代表在该波长范围内积分的发色团的浓度。 In which the use of optical systems with specially selected and / or modulated (Fig. 2) records Example hyperspectral data, the use of LED groups from each image represents light to record data points within the wavelength range Hair concentrations of chromophores. 例如,当用第2和4LED组(其优选地被选择和调制来模拟或者部分模拟氧合血红素吸收光谱)照明白反射器时,所记录的数据图像代表在第2和4 LED组整个波长范围内积分的、对于照明的HSI系统响应。 For example, when an image representative of the data (which is preferably selected and modulated to simulate or partially simulated oxyhemoglobin absorption spectroscopy) with the second group and 4LED reflector according to understand, as recorded in the Group 2 and 4 LED entire wavelength the range of credit, for the lighting of HSI system response. 当用第2和4 LED组照明皮肤时,所记录的数据图像与从校准器获取的数据图像相差了在第2和4 LED组整个波长范围内积分的皮肤氧合血红素吸收量。 When using the 2 and 4 LED group lighting skin, image data recorded with image data obtained from the calibrator difference of skin absorption in oxyhemoglobin and 4 LED Group 2 over the entire wavelength range of integration. 与校准器数据图像进行参比的皮肤数据图像具有关于由氧合血红素导致的皮肤吸收的信息,此外还有关于斜率和偏移分量的信息。 Calibration data and reference image data of an image having a skin on the skin caused by the oxyhemoglobin absorption of information, in addition to information about the slope and offset component. 对于用第3 LED组照明的情况进行类似的步骤,其中记录了由于脱氧血红素导致的皮肤吸收,此外还记录了斜率和偏移分量。 In the case of using the first set of 3 LED lighting similar step, which records the cause of the skin due deoxyhemoglobin absorption, in addition to recording the slope and offset components. 对于第1 LED组(其中氧合血红素和脱氧血红素在相似的浓度下具有相同吸收)的皮肤反应确定了皮肤中的总血红素浓度。 For the first 1 LED group (including oxyhemoglobin and deoxyhemoglobin at similar concentrations has the same absorption) skin reactions determine the total hemoglobin concentration in the skin. 得自第1、 2、 3和4LED 组的数据图像之间的差别允许评估斜率和偏移光谱分量,并且确认氧合血红素和脱氧血红素浓度。 From 1, 2, 3, and data of the image 4LED difference between groups to allow assessment of slope and offset spectral components, and make sure oxyhemoglobin and deoxyhemoglobin concentration. 最后,对于第5和6 LED组的皮肤响应和这两者之间的差别确定了水的浓度,并且允许评估组织水合水平。 Finally, in response to the difference between the skin 5 and 6 LED groups and between the two determines the concentration of water, and allow to assess tissue hydration levels. 得自所述LED组中的任意一组或者全部的数据可以被用于评估给定生理状态。 From the LED group in any one group or all of the data can be used to evaluate a given physiological state. 或者,所述LED组中的任意一组或者全部可以与其它光谱分离技术组合使用,以收集光谱的相似或者其它部分中的数据。 Alternatively, the LED group may be any or all of a set of spectroscopic techniques in combination with other separation using similar or data collection in other parts of the spectrum. 例如,可见光LCTF系统可以与类似于第5和6 LED组的LED系统一起使用,以在关于水浓度的红外数据上增加由可见光谱提供的数据(诸如血红素)。 For example, visible LCTF system can be used with similar groups 5 and 6 LED LED system to the infrared data on the increase in water concentration data provided by the visible spectrum (such as hemoglobin). 对于本发明,优选的是,至少组织氧合血红素和脱氧血红素被计算或者估计(还可利用诸如水丰度之类的其它量)。 For the present invention, it is preferred that at least tissue oxygenation hemoglobin and deoxy-hemoglobin is calculated or estimated (other amounts may also be used, such as the abundance of water, and the like). 在这些被估计的丰度被分别表示为OxyHb和DeoxyHb的情况下,血液总血红素(Thb)可以从下式得到:THb = OxyHb + DeoxyHb。 These are estimated in abundance are shown as OxyHb and DeoxyHb case, the total blood hemoglobin (Thb) can be obtained from the following equation: THb = OxyHb + DeoxyHb. 相对组织氧饱和度(SHSI02)可从下式得到:SHsi02 = OxyHb / THb* 100。 Relative tissue oxygen saturation (SHSI02) from the following equation: SHsi02 = OxyHb / THb * 100. 注意,这些量(Thb和SHSI02)是超光谱分解的伴随结果,并且如同它们与在医学文献中经常被引用的类似测量相关那样而被计算。 Note that these amounts (Thb and SHSI02) is accompanied by the results of hyperspectral decomposition, and as they relate to similar measurements in the medical literature is often cited as being calculated. 而且,超光谱所得的数据图线可以被剪切,以去除极端值。 Moreover, hyperspectral data obtained graph can be cut to remove extreme values. 在从数据图像计算矩阵之前,可以采用利用低通滤波器(诸如Gaussian滤波器)的平滑来改善数据图像。 Matrix calculated from the data before image, may be used with a low-pass filter (such as a Gaussian filter) to improve the smoothing image data. 接着,在本发明用于评估休克的一个应用中,得到反映休克或者濒临休克的临床征候的指标。 Then, in an application of the present invention is used to assess the shock of the reflected shock or a shock on the verge of clinical signs of indicators. 对于整个或者部分ROI执行附加的分析步骤,包括但不限于平均指标、不均匀性指标、色斑指标、时域指标以及组合的计算。 For the whole or part of the ROI to perform additional analysis steps, including but not limited to the average index, the uneven index, stain index, indicators and time-domain calculation combinations. 优选地,开头三个算法中的任何一个或者全部被用于得到这些休克相关指标。 Preferably, the beginning of the three algorithms are used for any or all of these shock obtain relevant indicators. 第4算法描述了休克反应的可能的病人后果或者严重性:可逆还是不可逆休克。 Chapter 4 describes the shock response algorithm possible consequences or severity of the patient: reversible or irreversible shock. 算法第1算法对反映休克的临床征候的标记进行定量,其是对于整个图像或者整个ROI的特性标记,例如ROI的整个或者选定部分上的超光谱测量的平均值或分布。 Algorithm 1 Algorithm to reflect clinical signs of shock quantitative marker, which is characteristic for the entire image or the entire ROI marker, such as an average or distributed over the spectrum measurement portions on the entire or a selected ROI. 例如,出血性休克的早期临床征候是总血液量的下降, 由此导致的皮肤特别是身体外周部分中的血液供应和血液氧合的下降。 For example, hemorrhagic shock early clinical signs of a decline of the total blood volume, the resulting skin, especially the outer periphery of the body portion of the decline in blood supply and blood oxygenation. 这是由于血液损失,以及身体通过限制血液流动到身体的外周部分来试图补偿休克、血容量过低或血液损失两者原因造成的。 This is due to blood loss, and restrict blood flow through the body to the outer periphery of the body to try to compensate for shock, hypovolemia, or both causes blood loss. 这通常导致可用于在休克的病人监测期间被成像区域的总的血液量和氧合血液量的下降。 This usually results can be used to be the total blood volume and oxygenation of blood volume decline imaging area of patient monitoring during shock. 相反地,与到皮肤的低流量相关的,从可用的有限量的血液的氧提取更大,并且脱氧血红素相对升高。 Conversely, with the low-flow-related skin from the limited amount of oxygen available are extracting more blood, and the relative increase in deoxyhemoglobin. 给定所有形式的血红素的总的下降,此脱氧血红素的相对升高可以导致总脱氧血红素的升高、降低,或者导致在休克开始之前或者与之相关的的总脱氧血红素的相似水平。 Given all forms of heme overall decline, the relative increase in deoxyhemoglobin this can lead to elevated total deoxyhemoglobin, reduce, or cause or associated with similar total deoxyhemoglobin before the shock start level. 为了得到对于给定ROI的平均值,可以通过计算超光谱数据图像上的值的诸如平均值、中值、固定百分点测量之类的量,直接计算血液和/或组织氧输送、氧提取、氧饱和度、总血红素、或者水含量的总体量的变化。 In order to obtain an average value for a given ROI can be calculated by the average of the values such as hyperspectral image data, the median amount of fixed points like measuring the direct calculation of blood and / or tissue oxygen delivery, oxygen extraction and oxygen saturation, total hemoglobin, or the overall amount of water content changes. 对于此应用,从每一个分量数据图像得到单个数字。 For this application, you get a single digit from each component data image. 对于此情形,相对于点测量,数据图像的优点在于,由大量被平均的点提供的积分得到了更精确的估计。 For this case, with respect to the point of measurement, the advantage is that the data of the image, is provided by a large number of points Average point was a more accurate estimate. 图5示出了从示例性猪受试者得到的数据结果。 Figure 5 shows the results of the data obtained from the example of porcine subjects. 对于在基线和在休克期间获得的氧饱和度的超光谱计算图像形成直方图。 For calculation of baseline and hyperspectral images acquired during shock forming oxygen saturation histogram. 此直方图表面氧饱和度的平均值的减小提供了关于此受试者的循环休克的提示。 This reduced the average surface oxygen saturation histogram provides information on this subject prompted circulatory shock. 图6示出了由示例性人受试者得到的数据结果。 Figure 6 shows the results of the data obtained by the example of a human subject. 在虚脱之前,总血红素急剧下降。 Prior to collapse, a sharp decline in total hemoglobin. 如果条件允许,可以在病人明显不处于休克状态时从其获得基线读数。 If conditions permit, you can get a baseline reading from which the patient is obviously not in a state of shock. 在此情况下,平均氧合等的变化可以与基线状态进行参比。 In this case, the average change from baseline oxygenation status can reference. 当可能时,基线的使用是有利的,因为其帮助去除病人与病人之间的差异。 When possible, use the baseline is advantageous because it helps to remove the differences between the patient and the patient. 即使不用基线,顺序测量的趋势可以提供重要信息。 Even without a baseline trend of sequential measurements can provide important information. 在急救环境下,可能不能获得基线,并且基于原始(未标准化)的量,或者参比从多个其它个体得到的标准基线,进行对于休克检测的判断。 In the emergency environment, you may not get a baseline, and based on the original (not standardized) of the amount of the standard baseline or reference from a plurality of other individual was subjected to shock testing judgments. 由在NIR区域(950-1100nm)中的皮肤吸收估计的水含量随着人受试者经历低体压的下降而变化。 In the NIR region from the skin (950-1100nm) absorbed in the estimated water content of the subjects as people experiencing low pressure drop and change the body. 图8示出了在虚脱之前组织中的水浓度降低了几乎10。 Figure 8 shows a prior collapse organization of water was reduced by almost 10. %。 %. 类似于在可见光范围内测量的总Hb和氧饱和度的标准差, 水也是预测休克的最有效的标记之一,因为在虚脱的很久之前(在此情况下IO分钟)其发生明显变化。 Standard Total Hb and oxygen saturation measured in the visible range is similar to the difference in the water is one of the most effective predictive marker of shock, because for a long time before the collapse (in this case IO minutes) which change significantly. 水在近IR区中测量,这在战场中是更有利的。 Water in the near-IR region of the measure, which is on the battlefield is more favorable. 除了数据图像中的分量:血红素、氧合血红素、脱氧血红素、SHSI02 和H20,的平均值变化之外,分量的数据图像中的分布和/或标准差也变化。 In addition to the data in the image component: Out of hemoglobin, oxyhemoglobin, deoxyhemoglobin, SHSI02 and H20, the mean change in the image component data distribution and / or standard deviation also changes. 这些变化涉及与休克或者血容量过低相关的皮肤氧输送/提取和水合的不均匀模式的出现增多的情况。 These changes involve shock or low blood volume associated with skin oxygen delivery / extraction and hydration uneven pattern of number of cases. 图7示出了从人受试者得到的数据结果。 Figure 7 shows the results of the data obtained from a human subject. 在血液动力学虚脱之前,SHSA图像中的不均匀性升高。 Before hemodynamic collapse, SHSA image unevenness increases. 第2算法对反映休克的临床征候的并且涉及氧输送/提取中的更局部的变化的标记(例如,皮肤的色斑)进行定量。 Second algorithm reflect the clinical signs of shock and involve marked oxygen delivery / extraction of more localized changes (for example, skin pigmentation) was quantified. 与氧合的点测量不同,超光谱成像能够拍摄关于色斑图案的信息。 And point measurements of different oxygenation, hyperspectral imaging can capture information about the stain pattern. 色斑的出现可以被检测,并且可以利用各种图像处理算法来表征色斑图案。 Stain occurred can be detected, and the pattern of spots may be characterized using various image processing algorithms. 下面描述了四种用于检测和评估色斑及其变化的独立方法。 The following describes the four independent methods for the detection and assessment of spots and change. 作为用于评估色斑的第1方法,可以确定色斑图案的尺寸。 As a first method used to evaluate the stain, you can determine the size of the stain patterns. 如前面所述,随着休克的邻近,整个HSI图像的不均匀性增加。 As previously described, with the adjacent shock, the entire increase in HSI image unevenness. 可以在较小尺寸的区域估计增大的不均匀性的量度,诸如分布的标准差(std)或者基于百分点的测量(例如,图像的第75和第25的四分位值之间的差)。 You can estimate the inhomogeneity measure increases in the area of smaller size, such as the standard deviation of the distribution (std) or percentage based measurements (for example, the difference between 75th and quartile values of the image between the 25th) . 当目标区域与色斑图案尺寸相当时,区域内的分布降低(与在整个图像上的增大的std相比),反映了在色斑区域内的均匀性。 When an area of considerable size and pigmentation pattern, the distribution area decreased (compared to an increase in the overall image of std), reflecting the stain area in uniformity. 作为ROI尺寸的函数的不均匀性的变化可以用于评估色斑图案的尺寸。 As unevenness ROI size change function can be used to evaluate the size of the stain pattern. 作为用于表征色斑的第2方法,可以利用图像复杂度的量度表征色斑尺寸和形状。 The second method is used to characterize the stain, you can use a measure of image complexity characterizing the size and shape of the stain. 优选地,这可以对于具有高值的区域利用面积对周长量度。 Preferably, this region can use the area for a high value of the measure of the perimeter. 更优选地,上述的数据图像(氧合等)可以经由图像处理技术被处理,以生成描述反应的"高"和"低"区域的二元图像。 More preferably, the above-mentioned data of the image (oxygenation, etc.) can be processed by the image processing technology to generate describe the reaction of the "high" and "low" dual image area. 此二元图像可以利用多种方法来生成。 This two yuan image can be generated using a variety of methods. 在一个实施例中,使用边缘检测方法来确定目标区域。 In one embodiment, an edge-detection method to determine the target area. 这些边缘然后被填充,以形成二元图像。 These edges are then filled, to form binary images. 在第二实施例中,图像首先被滤波,以去除低频波动。 In the second embodiment, the image is first filtered to remove low-frequency fluctuations. 然后利用Ostu方法或者相当的阈值方法,确定用于经滤波图像的阈值。 Then use Ostu method or equivalent threshold methods to determine the threshold for the filtered image. 阈值用于确定二元图像中的"高"和"低"区域。 Two yuan threshold used to determine the image of the "high" and "low" area. 一旦生成二元图像,可以得到所有"高"区域的面积和求和的周长。 Once generated binary image, you can get all the "high" area of the region and the sum of the perimeter. 这些参数的比值提供了对于色斑的量度。 The ratio of these parameters provides a measure of the stain. 如果大的"斑状"起斑区域存在于成像区域中,则它们将往往具有较低的周长对面积的比值。 If the big "patchy" and spot region exists in the imaging area, they will tend to have a lower ratio of the circumference of the area. 如果成像区域较均匀,则"高"和"低"区域将往往是小的,对应于从局部背景偏移的小的区域。 If the imaging area is uniform, the "high" and "low" area tend to be small, which corresponds to a small area offset from the local background. 因此,这些较小区域的平均周长对面积比值小于起斑的受试者。 Thus, the average circumference of these smaller area ratio is smaller than the area of a subject from the spot. 作为用于表征色斑的第3方法,可以利用滤波增强明显偏离平均值的相邻区域。 As a third method for the characterization of the stain, you can use the filter to enhance the apparent deviation from the average value of the adjacent area. 该方法利用了色斑的两个方面:第一,起斑区域通常具有明显不同于平均值的氧合或者其它值;第二,起斑区域通常较大而不是较小。 The method makes use of two spots: the first, from the spot region typically have significantly different from the mean value of oxygenation or other; second, from the spot area is usually larger and not smaller. 在此方法中,首先形成二元图像,其确定超光谱图像中所有与平均值相差用户规定量的像素。 In this method, firstly to form binary image, which is determined hyperspectral image all users with a predetermined amount of difference between the average of the pixel. 作为实例,可以被确定的区域是1)大于平均值加上若干倍的标准差;或者2)小于平均值加上若干倍的标准差。 As an example, the region may be determined that a) a number of times greater than the mean plus standard deviation; or 2) a number of times smaller than the mean plus the standard deviation. 该方法不明确要求使用平均值;例如,可以使用与经低频滤波的图像版本的偏差。 This method does not explicitly require the use of an average value; for example, you can use low-frequency deviation and filtered version of the image after the. 此初步二元图像可以确定具有极端值的区域。 This preliminary binary image area can be determined to have extreme values. 作为第二阶段,二元图像被滤波,以去除不与至少N个其它像素相连的像素,其中,N是用户选定参数,其被选择来代表对于起斑区域的最小生理合理尺寸。 As a second stage, the binary image is filtered to remove at least N pixels and not connected to other pixels, wherein, N is the user selected parameters that are selected to represent a reasonable size for the spot from the minimum physiological region. 此第二步骤得到明显不同于平均值的相连像素(即,起斑区域)的二元图像。 This second step has been markedly different from the average value of connected pixels (ie, from the spot region) binary image. 然后,所有这样的区域的面积被求和,得到代表图像中的起斑程度的衡量标准。 Then, all the area of the region such are summed to give a representative image of the spot from the degree measure. 此方法的实例被示于图9。 Examples of this approach is shown in Figure 9. 作为表征色斑的第4方法,评估数据图像或者生理参数(诸如,血液氧合或者饱和度,或者水合状态)图像中色斑程度随时间的变化。 As a fourth method of characterization spots, evaluate data image or physiological parameters (such as blood oxygenation or saturation, or hydrated state) image changes over time in the degree of pigmentation. 此方法利用了如下事实:由超光谱系统成像的生理参数因为身体试图补偿休克而动态变化。 This method takes advantage of the fact that: the physiological parameters hyperspectral imaging system as the body tries to compensate for shock and dynamic change. 皮肤色斑图案偏移,以保护血管收縮的区域中的组织可存活性,并且在休克之前或者随着休克进程,这样的偏移发生得更快。 Skin pigmentation pattern shifted to protect the blood vessels in the region of tissue viability, and before the shock or with the shock process, this shift occurs faster. 优选地,得到两个参数来测量色斑变化性,"斑点"和"时域"。 Preferably, two parameters were obtained to measure the stain variability, "spot" and "time domain." 为了表征这些参数,优选地将超光谱图像转化为"高"、"低"和零值的三值图像(参见图10的顶部原始图线,其中,绿色为零、红色和蓝色分别对应于S腦02的"高"和"低"值)。 In order to characterize these parameters, preferably ultra-spectral image into "high", the three-value image "low" value and zero (see FIG. 10 of the top line of the original image, wherein, zero green, red and blue, respectively corresponding to S Brain 02 "high" and "low" value). 在该原始图线中的每一个图线对应于实验内(从基线开始并且朝向休克进展(最后之前的图像的LBNP=-90))的特定时间,并且最后的图像回到平衡。 Each plot lines in the original image corresponding to the experimental (from baseline and progress towards the shock (the last image before LBNP = -90)) of a particular time, and the final image back to balance. 斑点表示斑尺寸,并且其被计算为红色和蓝色像素的总和,并且被简化为一个数值,该数值在朝向虚脱的过程中随时间增大(图IO下方图片中的绿线)。 Dot represents a spot size, and it is calculated as the sum of the red and blue pixels, and is reduced to a value which in the process towards collapse increases with time (Fig IO below the picture of the green line). 衡量色斑变化性的时域参数是基于任何或者所有HSI测量或获得量的两个顺序图像之间的比较。 Temporal variability of parameters to measure the stain is based on any or all of the HSI measurements or to compare two sequential images obtained between the amount. 优选地,这些包括但不限于,OxyHb、 DeoxyHb、 Thb、 SHSI02、水和单波长图像(它们单独或者组合使用)。 Preferably, these include, but are not limited to, OxyHb, DeoxyHb, Thb, SHSI02, water, and single-wavelength images (either alone or in combination). 更优选地,其包括但不限于OxyHb和DeoxyHb数据图像。 More preferably, including, but not limited to OxyHb and DeoxyHb data image. 在顺序上稍后的图像被套准到前一图像上,然后被与前一图像上减去(或者相反),并且分析所得图像。 Later in order to associate the image fitted on the previous image, is then subtracted (or vice versa) with the previous image, and analyzing the resultant image. 作为这样的分析的实例,在此,具有小的变化(例如,小于1的标准差)的区域被指定为零(在图10中的第二原始图线中的深蓝色)。 As an example of such an analysis region, and in this, with a small change (e.g., less than 1 standard deviation) is specified as zero (in FIG. 10 of the second original image of the dark blue line). 具有正变化的区域(例如,增大的氧合)被上以红色阴影,而负变化的区域(例如,减小的氧合)被上以蓝色阴影。 A positive change in the region (for example, increased oxygenation) is on the red shadow, while a negative change in the region (for example, reduced oxygenation) is a blue shadow. 这些区域(正和负两者)然后用其最大幅值按比例衡量,并且在整个图像上进行求和。 These areas (both positive and negative) and then use it in proportion to the maximum measured amplitude, and summed over the entire image. 于是, 色斑的时域变化性被简化为一个数值,其可以作为时间的函数被作图(参见图10中的下方图片中的蓝线)。 Thus, the stain temporal variability is reduced to a value which can be plotted as a function of time (see Figure 10 in the image below in the blue line). 在许多情形中,时域分量(蓝线)的增大先于斑点分量(绿线)的增大。 In many cases, the time-domain component (blue line) increases to increases in spot components (green line). 时域和斑点分量的水平提供了对于受试者在试图补偿休克时反应的快速程度的量度,并且是生理应激的指示。 Level time domain and spot component provides for compensation when the subject in an attempt to measure how quickly shock response, and is an indication of physiological stress. 优选地,这样的四种方法中的一种或者多种被使用来评估色斑。 Preferably, this four methods were used to evaluate one or more of the stain to use. 更具体地,这些方法中的两种以上的方法可以组合来计算色斑指标。 More specifically, these methods may be combined two or more methods to compute stain index. 更优选地, 斑点和时域方法被组合来计算时域色斑指标。 More preferably, the spot and time domain methods are combined to calculate the time-domain stain index. 用于检测休克的第3算法将两种前面描述的算法组合:整体图像分析和局部色斑分析。 Algorithm combinations for detecting shock third algorithm the two previously described: overall image analysis and analysis of the local spots. 上面定量的反映休克的临床征候的所有标记被简化为一个单值,其依赖于受试者的生理和代谢状态随时间变化。 All marks above reflect quantitative clinical signs of shock is reduced to a single value, which depends on the physiological and metabolic status of the subject changes over time. 这些数据的线性或者非线性组合接近用于特定受试者的超光谱休克指标(HyperSpectralShock Index, HSSI)量度。 Linear or non-linear combination of these data is close hyperspectral shock index (HyperSpectralShock Index, HSSI) metrics for a particular subject. 作为实例,使用相对HSSI标度(其中,测量值大于1被认为是休克的指示),利用峰值和下降,可以在所绘制的图线上见到瀕临脉管虚脱的证据。 As an example, using relative HSSI scale (where the measurement value is greater than 1 is considered to be indicative of shock), the use of the peak and decline, we can see evidence on the verge of collapse in the vasculature of the plotted lines. HSSI充当了非常灵敏的循环调控的衡量标准,并且当存在由于升高的LBNP水平导致的初始全身性损伤时上升,然后当补偿机制发生时回落。 HSSI act as a very sensitive measure cycle regulation, and increased when there is due cause elevated levels of LBNP initial systemic damage, and then back down when the compensation mechanism occurs. 最后一个算法描述用于检测图像中的特征的方法,所述特征可以指示休克反应的可能的病人后果或者严重性:可逆或者不可逆休克。 The final algorithm is described a method for detecting image feature, the feature may indicate the possible consequences or severity of the patient's shock response: reversible or irreversible shock. 如本文前面所述,通过揭示皮肤的均匀变化和色斑,多种测量支持对于休克的早期检测。 As described earlier in this article, by revealing a uniform skin pigmentation changes and a variety of measuring support for the early detection of shock. 目前的研究也已经示出了超光谱图像通过揭示皮肤中的微循环模式的变化,可以提供关于病人可存活性的提示。 The current study has shown a hyperspectral image by revealing changes in the skin microcirculation mode can provide tips on the patient can survive in nature. 图11示出了猪受试者在出血之前(左侧图片,27分钟之前)、在休克期间(在最初出血之后62分钟)、以及复生后(在最初出血之后2小时)的示例性超光谱氧合血红素图像。 Figure 11 shows a pig bleeding subjects before (left image, 27 minutes) before, during shock (62 minutes after the initial bleeding), and after resuscitation (two hours after the initial bleeding) of an exemplary hyper-spectral oxyhemoglobin images. 受试者已经发展了大的快速变化的色斑图案,这可能与交替的高和低氧合血红素水平相关。 The subject has developed a large stain pattern of rapid change, which may be associated with alternating high and low-oxygen combined hemoglobin levels. 在复生之后循环模式已经恢复(比较图11中的第3和第l个图像)。 After the rebirth cycle mode has been restored (compare Fig. 11 in the third and l images). 另一个动物受试者(图12)已经发展成S服02图像中的明显的"羽毛状"图案。 Another animal subjects (Figure 12) has developed into S clothing 02 image obvious "feathery" pattern. 该图案在该过程中死亡或者对于该测试过程没有表现出强劲恢复的许多测试受试者中发展,并且似乎指示了不利后果的更大可能性。 The pattern of death in the process or for the test procedure showed no recovery in the number of test subjects in the development of strong and appears to indicate a greater likelihood of adverse consequences. 将这样的指示提供给医疗人员可能是很有价值的。 Such indication is provided to medical personnel may be valuable. 通过使用图像处理方法来检测可能是"羽毛状"的图像中的边缘和特征,可以检测在图12中观察到的羽毛状图案。 By using the image processing method to detect may be "feathered" edges and image characteristics, can be detected observed in Fig. 12 feathery pattern. 除了上述的表征色斑的方法(不同尺寸ROI的分布值,面积对周长比、色斑斑点的短轴对长轴的比),可以应用另一种可能的实施方式。 In addition to the above-described method of characterizing stain (ROI distribution value of different sizes, the area ratio of the circumference, pigmentation spots on the major axis than the minor axis) may be applied another possible embodiment. 可以构建一个图像模板,该图像模板可以被构造成类似于整个羽毛状特征或者其子部分(例如,其单个分枝)。 Can build a template image, the template image may be configured similar to the whole or a sub-feature feather portions (e.g., the individual branches). 此模板的縮放和旋转版本可以被与超光谱图像相关,以生成"匹配"分数。 Scaled and rotated version of this template can be associated with hyper-spectral image to generate "match" score. 在图像的区域中的高匹配分数的出现可以被当作在图像中出现"羽毛状"的指示,并且将得到被提供给医疗人员的警告。 In the regions of the image appear high match score may be deemed to occur in the image of "feathered" instructions, and will get a warning is provided to the medical staff. 此图像处理方法与由Delanoy等描述的方法类似,但是其之前没有被应用于休克的超光谱检测、可存活性评估、复生充分性的评估或者生理状态的其它评价。 This image processing method similar to the method described by the Delanoy the like, but hyperspectral detector which has not previously been applied to the shock, viability assessment, other evaluation or assessment of the adequacy of resuscitation physiological state. 下面的实例说明了本发明的实施例,但是不应被视作限制本发明的范围。 The following examples illustrate the embodiments of the present invention, but should not be considered as limiting the scope of the invention.

实例 Examples

首先,选定目标ROI,优选地其是局部化的组织,并且更优选地,一小块皮肤,并且最优选地,诸如前臂的毛发较少并且较平坦的一小块皮肤。 First, targeting ROI, preferably it is localized tissue, and more preferably, a small piece of skin, and most preferably, such as a forearm hair and less than a small piece of skin flat. 优选的其它可能位置包括颊、大腿、面颌区域。 Preferred Other possible locations include cheek, thigh, face jaw area. 在可选实施例中,局部化组织是颊黏膜,直肠黏膜,膀胱黏膜,腹内绒膜或者其它可用于成像的组织。 In an alternative embodiment, the localized tissue is buccal mucosa, rectal mucosa, bladder mucosa, abdominal chorionic or other organizations for imaging. 然后,我们在预定的距离处或者在根据测量或估计或记录的距离处,收集来自ROI或者ROI的一部分的光谱数据。 Then we at a predetermined distance or the distance measured or estimated or recorded, collect spectral data from a portion of ROI or ROI. 优选地,该距离小于IO英尺,并且更优选地,在6和36英寸之间,并且最优选地,在12和18 英寸之间。 Preferably, the distance is less than IO feet, and more preferably, between 6 and 36 inches, and most preferably, between 12 and 18 inches.

在另一个实施例中,优选的距离是0.1到6英寸之间,更优选地,在0.5到2英寸之间。 In another embodiment, the distance is preferably between 0.1 to 6 inches, more preferably between 0.5 to 2 inches. 在另一个实施例中,优选的距离在IO英尺到IOOO英尺之间,更优选地,在10到300英尺之间,并且更优选地,在10到100英尺之间。 In another embodiment, the preferred distance between the IO feet IOOO feet, more preferably between 10 to 300 feet, and more preferably, between 10 to 100 feet. 在每一个实例中,优选地,进行对光学器件的调节,以提供合适的分辨率。 In each instance, it is preferred to carry out the adjustment of the optical device, to provide a suitable resolution. 优选地,用自动縮放光学器件收集数据。 Preferably, the automatic zoom optics to collect data. 在另一个实施例中, 系统需要固定的焦距。 Embodiment, the system requires a fixed focal length in another embodiment. 在另一个实施例中,使用对光学器件的手动调节, 以获得所期望的视场和图像分辨率。 In another embodiment, the use of the manual optics adjustment to achieve the desired field of view and image resolution. 优选地,使用预定的光学设置,或者自动或者手动地测量或者估计或者记录自动或者手动选定的光学设置。 Preferably, the predetermined optical settings, either manually or automatically measured or estimated or recorded automatically or manually selected optical setup. 优选地,采用图像稳定化技术。 Preferably, the use of image stabilization technology. 获取一个或者一系列图像。 Get one or a series of images. 如果多于一个的图像被获取,则可以以预定间隔,或者以被测量或者估计或者记录的间隔收集顺序的图像。 If more than one image is captured, it can be a predetermined interval, or to be measured or estimated, or image recording intervals collection order. 优选地,以10毫秒到1小时之间的间隔收集顺序的测量结果。 Preferably, in order to collect the measurement interval to 10 milliseconds between the results of one hour. 更优选地,以IO毫秒到IO分钟之间的间隔收集测量结果。 More preferably, the IO millisecond intervals to collect measurements IO minutes. 最优选地,以10毫秒到1分钟之间的间隔收集测量结果。 Most preferably, at intervals of 10 milliseconds to one minute between the collection of measurements. 在另一个实施例中,优选地以约1毫秒到1分钟之间的间隔、更优选地以1毫秒到1秒之间的间隔收集测量结果。 In another embodiment, preferably at intervals of about 1 millisecond to 1 minute between, more preferably at intervals of 1 millisecond to 1 second between collection of measurements.

优选地,仪器被构造为被固定到可移动推车、台、壁或者顶板工作夹具上的自立式设备。 Preferably, the instrument is configured to be secured to the free-standing device movable cart, wall or on the ceiling fixtures. 更优选地,其是小型手持设备。 More preferably, it is a small hand-held devices.

在另一个实施例中,其整体或者部分地安装在诸如双筒镜或者枪的瞄准器的其它光学设备中或者与其组装。 In another embodiment, in whole or in part, installed in other optical devices such as binoculars or a gun sight or assembled thereto.

在另一个优选实施例中,设备将被紧靠身体保持。 In another preferred embodiment, the device will be maintained close to the body. 更优选地,设备和身体之间的关系将被保持相对固定。 Relationship More preferably, the equipment and the body will be kept relatively fixed. 更优选地,非压縮性带可以将设备的一部分固定在皮肤上方的位置上,用于连续或者间歇的读数。 More preferably, the non-compressed portion of tape can be fixed to the device in position on top of the skin, for continuous or intermittent readings.

从ROI的一个或多个图像收集相关的光谱数据。 Images collect spectral data from one or more of the ROI. 优选地,在1和1000 个波长带之间,更优选地在2到IOO个带之间,甚至更优选地在2到60个带之间并且最有选地在2到25个带之间进行收集。 Preferably, between 1 and 1000 wavelength band, more preferably between 2 to IOO a band, even more preferably between 2-60 band and most optionally between 2-25 with collected. 在另一个实施例中, 优选地在2到10个带之间,更优选地在3到5个带之间进行收集。 In another embodiment, preferably between 2-10 with, and more preferably between 3-5 with collected. 优选地,从其收集数据的光谱区域在450到1200nm之间。 Preferably, the data collected from the spectral region between 450 and 1200nm.

出血性休克 Hemorrhagic shock

在胸外伤和出血之后皮肤氧饱和度(sHSIo2)变化被观察,这对于肉 Skin oxygen saturation (sHSIo2) change was observed after chest trauma and bleeding, which for meat

眼是不明显的,但是产生具有显著的色斑图案的超光谱图像。 Eye is obvious, but produce hyperspectral images have a significant stain pattern. 在猪模型中 In a porcine model

在出血休克期间,皮肤的S^02图像的图像强度减小,指示皮肤中的氧饱 During hemorrhagic shock, skin S ^ 02 image image intensity decreases, indicating that the oxygen saturation in the skin

和度降低。 And decreased.

使用17头雌性约克夏(Yorkshire)猪(9头分入出血组,8头分入对照组),其体重为36.4 0.11 kg。 Use 17 female Yorkshire (Yorkshire) pigs (9 minutes into the bleeding group, eight minutes into the control group), the body weight of 36.4 0.11 kg. 这些动物被检疫一个星期,并且在程序之前整夜禁食。 The animals were quarantined for a week, and fasted overnight before the program.

动物术前用药250 mg IM Telazol。 Animal premedication before 250 mg IM Telazol. 在由通过面罩输送的异氟醚引入麻醉之后,将它们保育,并且放置在Datex-Ohmeda麻醉呼吸机上, 一次呼吸体积为10ml/kg,并且呼吸速率为12/分钟。 After the mask delivered through the introduction of isoflurane anesthesia, will they care, and placed on Datex-Ohmeda anesthesia ventilator, a breathing volume of 10ml / kg, and respiratory rate of 12 / min. 调节该速率,以获得正常二氧化碳量(PaC02 = 35-45 mm Hg)。 Adjust the rate to get the normal amount of carbon dioxide (PaC02 = 35-45 mm Hg). 用异氟醚(2-2.5%)和室内空气的混合物维持麻醉。 Isoflurane (2-2.5%) and a mixture of indoor air to maintain anesthesia. 将经皮鞘导引器两侧地插入到颈动脉和颈外静脉,并且10F的Floley导管被插入到膀胱中。 The introducer sheath is inserted percutaneously into the carotid artery and the land on both sides of the external jugular vein, and the Floley 10F catheter is inserted into the bladder. 通过中线剖腹手术进行脾切除术。 Through a midline laparotomy splenectomy. 在脾切除术之前脾动脉被打结,以允许血液从脾脏排到循环系统中。 Splenic artery was knotted before splenectomy to allow the blood from the spleen discharged circulatory system. 在脾切除之后立即施予1.5倍脾脏重的乳酸化的Ringer溶液(LR)灌注。 Immediately after the administration of 1.5 times splenectomy spleen weight of Ringer lactate solution (LR) perfusion. 在手术结束时,将异氟醚减小到0.6%,并且开始灌注克他命(ketamine) (250-350 pg/kg/min)。 At the end of surgery, isoflurane is reduced to 0.6%, and begin infusion of ketamine (ketamine) (250-350 pg / kg / min). 持续该克他命-异氟醚麻醉,直到研究结束。 Continued the Ketamine - isoflurane anesthesia, until the end of study. 根据需要进行麻醉深度评估和麻醉剂量调节。 Anesthesia and anesthesia-depth assessment dose adjusted as needed. 通过外部加热垫将核心温度维持在37-39C之间 Pad maintained core temperature at between 37-39 C by external heating

经由颈外静脉导引器鞘插入导流肺动脉导管,以允许测量混合的静脉血气和核心温度。 Via the external jugular vein introducer sheath insertion diversion pulmonary artery catheter, to allow measurement of mixed venous blood gas and core temperature. 颈动脉导引器鞘中的一个被用于测量动脉血压 Carotid sheath introducer is used to measure an arterial blood pressure

(ABP)。 (ABP). 使用临床压力传感器。 Clinical use of the pressure sensor. 由心电图获取心率。 Get the heart rate from the ECG. 利用热电偶在两个后肢处监测区域皮肤温度。 Two hind legs with a thermocouple in the skin temperature of the monitored area.

在表1中给出了实验方案。 Table 1 shows the experimental program. 在术后稳定期间(1-2小时)之后,收集基线数据。 During stable after surgery (1-2 hours), the collection of baseline data. 然后,对出血组中的动物(HEM, n = 9)用注射器通过颈动脉管进行抽血。 Then, the blood group of animals (HEM, n = 9) with a syringe tube for blood through the carotid artery. 以恒定的速率,1 ml/kg/min,进行3次抽血,每次10 mVkg。 At a constant rate, 1 ml / kg / min, blood three times, each time 10 mVkg. 血被收集到包含CPDA抗凝血剂的袋中。 Blood is collected into a bag containing an anticoagulant CPDA. 在三次IO分钟的出血时间段的每一个之后紧接15分钟的观察时间段。 In each of the following three IO minutes bleeding time period immediately following the observation period of 15 minutes. 在第三观察时间段之后, 通过静脉内灌注1.5倍出血量的LR,使得动物复生。 After the third observation period, by intravenous infusion of 1.5 times the amount of bleeding LR, making the animal back to life. LR复生时间段的持续时间为25分钟。 LR resuscitation duration time period is 25 minutes. 然后,根据需要施予超过初始复生量的额外液体,以使得心率和血压朝基线值恢复。 Then, according to the needs exceed the initial resuscitation administered amount of additional liquid, so that heart rate and blood pressure towards baseline is restored. 在25分钟LR灌注时间段之后紧接着30 分钟的观察时间段,然后是其中出血被回注的25分钟时间段。 After 25 minutes reperfusion period LR observation period followed by 30 minutes, followed by re-injection in which bleeding time period of 25 minutes. 之后对动物再观察1小时,然后实施安乐死。 After one hour the animals and then observe, then euthanized. 利用流体加热器进行血和LR的回注。 The use of blood and fluid heater LR reinjection. 获得整个内后肢的HSI图像。 HSI access to the entire image in the hind legs.

对照组中的动物经历相似的手术准备,并且接受100ml/小时的维持LR灌注。 Animals in the control group experienced similar surgical preparation, and accept 100ml / hour to maintain LR perfusion. 在以下时间点获取数据:基线、在每次10 ml/kg抽血之后、在LR复生之后和在血回注之后。 Get data at the following time points: baseline, after each 10 ml / kg blood, after LR resuscitation and blood back after the injection.

抽血导致心动脉收縮压的早期下降,这在第一次抽血之后在统计上变得明显,并且一直保持下降直到LR复生之后。 Blood lead to early heart artery systolic pressure drop, which becomes apparent after the first blood sample statistically, and has been a downward until after LR resuscitation. 心率随抽血提高,但是是以延迟的模式——仅仅在第二次出血期间变得明显;其在出血回注之后恢复到对照水平。 Heart with blood increase, but at a delay mode - only become apparent during the second bleeding; it returned to control levels after bleeding reinjection.

所有HEM动物随血液损失示出了平均Shs!02的下降;这些变化在第 All animals with blood loss HEM shows a decline in the average Shs 02;! These changes in the first

三次出血之后变得明显。 After three bleeding becomes apparent. 它们在灰度sHSIo2图片上很明显,但是对于肉眼不明显。 They are evident in the gray sHSIo2 pictures, but not obvious to the naked eye. HSI OxyHb以及动脉碱过量和氧的混合静脉饱和度的减小在第2 次出血之后变得明显。 Reduce HSI OxyHb and arterial base excess and mixed venous oxygen saturation after the second bleeding becomes apparent. 这些变化通过复生全部可逆。 These changes through the resurrection of all reversible.

由在可见波长区域中的超光谱成像得到的皮肤的S服02和OxyHb图像的平均强度在出血性休克期间减小,并且在麻醉猪的复生期间恢复。 S served by the average intensity hyperspectral imaging in the visible wavelength region obtained 02 skin and OxyHb image during hemorrhagic shock decreases, and during resuscitation anesthesia swine recovery. 这些变化与在若干侵入获得的变量中观察到的那些大致类似,包括心动脉收縮压、动脉碱过量和氧的混合静脉饱和度。 These changes observed in the variable number of invasive broadly similar to those obtained, including mixed venous saturation heart artery systolic pressure, arterial base excess and oxygen. 但是,假定HSI提供关于血液 However, assuming HSI provide information on blood

动力学障碍和生理状况的额外信息,并且可以与HSI提高的更早的关于血 Additional information kinetics disorders and physiological conditions, and can increase the HSI earlier about blood

液动力学障碍和濒临虚脱的信息相关联,预计缺少紧密的相关性。 Fluid dynamics and on the verge of collapse disorder associated with information, is expected to lack the close correlation.

图5示出了得自示例性猪受试者的数据结果。 Figure 5 shows an example of the terrible pig subjects from the data results. 形成在基线处和在休克 Formed at baseline and in shock

期间获得的氧饱和度的超光谱计算图像的直方图。 Histogram hyperspectral images obtained during the calculation of oxygen saturation. 直方图示出了氧饱和度的平均值提供了关于对于此受试者的循环休克的提示。 Histogram shows the average oxygen saturation provided on circulatory shock for this subject of the tips.

在氧饱和度图像中,每一个像素的亮度与该像素的S皿02强度成正 In the oxygen saturation level image, S pan 02 luminance intensity of each pixel into the pixel n

比。 Ratio. 基线图像和在第三次出血后的时间段期间获得的图像都被包括了。 Baseline image and image during the time period after the third bleeding obtained are included. 在这些图像中,图像强度的减小是明显的。 In these images, the image intensity is reduced significantly. 定性地, 一些动物但不是全部, 在休克期间表现出色斑的增多,这在氧饱和度图像上也是明显的。 Qualitatively, some animals but not all, during the shock showing increased pigmentation, which is on the oxygen saturation level image is obvious. 这些变 These variants

化都是对于肉眼不明显的。 Technology are obvious to the naked eye. 定量地,这些SHSI02图像的平均灰度强度随着抽血线性下降,在第三次出血之后较之对照动物变得明显减小,并且通过复生恢复到对照水平。 Quantitatively, the average gray intensity SHSI02 image decreases linearly with blood, after the third bleeding becomes significantly reduced compared with the control animals, and returned to control levels by the resurrection.

对于ROI的OxyHb拟合系数的平均值也随着出血线性下降,但是其表现出更早的统计上的明显下降(在第二次出血之后),其也通过复生恢复。 For the average fit factor OxyHb ROI also decreases linearly with the bleeding, but it showed significant statistical decrease earlier (after the second bleeding), which is also restored by the resuscitation. 同时,对于ROI的平均DeoxyHb拟合系数在第三次出血期间和之后似乎趋向于上升,但是这些变化不明显。 Meanwhile, the average DeoxyHb ROI fit factor in the third period after bleeding and seemed tend to rise, but they did not change significantly. 作为色斑出现的程度的粗略指标,氧饱和度图像的灰度直方图的标准差似乎随着出血而增大,但是这不是统计意义上明显的。 As the extent of the stain appears rough indicator of the standard deviation of the oxygen saturation level histogram of the image seems to increase with the bleeding, but obviously this was not statistically significant. 激光多普勒成像显示随着血损失对于ROI的皮肤血流线性下降,这在第三次出血之后变得明显,并且通过复生可逆。 Laser Doppler imaging ROI for display as loss of skin blood flow decreases linearly, which becomes apparent after the third bleeding, and is reversible by resuscitation.

执行线性回归,以检查氧的混合静脉饱和度和SHM02之间的可能的关 Performs a linear regression to the possible shut mixed venous oxygen saturation and SHM02 inspection between

系。 Department. 该分析表明了线性关系,具有0.12的较低的r2 (p < 0.001, 114)。 The analysis shows that the linear relationship, with the lower r2 0.12 (p <0.001, 114). 与心动脉收縮压的相关性是类似的(r2 = 0.14, p< 0.001, df= 202)。 Systolic blood pressure and heart are similar correlation (r2 = 0.14, p <0.001, df = 202). 虽然激光多普勒图像强度似乎遵循与SHSI02的相似的时间进程,但是在线性回归中2个变量之间没有关系(r2 = 0.01, p = 0.312, df= 112)。 Although laser Doppler image intensity seems to follow a similar time course and SHSI02, but there is no linear regression relationship between two variables (r2 = 0.01, p = 0.312, df = 112).

在本专利中描述的休克监测方法采用了超光谱成像。 Shock monitoring methods described in this patent uses a hyperspectral imaging. 在此技术中,生成了具有每一个个体像素中的固有的光谱数据的二维图像。 In this technique, the two-dimensional image is generated for each individual pixel having inherent spectral data. 在优选的实施例中,每一个像素的光谱与各种化学物质的存在和浓度相关。 In a preferred embodiment, the spectrum of each pixel presence and concentration of various chemicals related. 此数据被解释为这些物质在表面中的丰度。 This data is interpreted as the abundances of these substances in the surface. 这具有与各种生理状况的高相关性,并且提供了改善代谢监测的可能性(图ll)。 This has various physiological conditions of high correlation, and offers the possibility of improved metabolic monitoring (Figure ll). 利用超光谱成像可以观察到若干种对于休克的反应(如在猪受试者的血量减少性休克中所见到的)。 Use of hyperspectral imaging can be observed for several shock reactions (such as reducing the amount of blood in the swine subject Shock seen). 第一,在许多受试者中观察到总氧合水平(或者氧饱和度)降低。 First, in many subjects observed total oxygenation level (or oxygen saturation) is reduced. 第二,在若干受试者的皮肤中观察到色斑的出现。 Second, the skin of a subject in a number of observed spots appear. 这是已知的休克指示,并且是由于在身体试图补偿引起生理应激的事件时血流的微循环模式的变化导致的。 This is a known indication of shock, and is given in the body attempts to compensate for changes caused by physiological stress event microcirculation blood flow patterns caused. 最后,可以发生独特的循环模式变化,导致"羽毛状"图案(图12)。 Finally, a unique circular pattern changes occur, leading to "feathery" pattern (Figure 12). 这些变化的循环模式似乎与不好的后果相关,因此提供了对于病人将进入不可逆休克的可能性的量度。 These changes appear to bad circulation patterns associated consequences, thus providing the possibility for the patient to enter a measure of irreversible shock. HSSI是4个标量因子的非线性组合,所述4个标量因子针对每一个动物在每一个时间步长上由应用于超立方体的图像处理技术获得。 HSSI is a combination of four non-linear scalar factor, said four scalar factor for each animal at each time step to get the hypercube applied image processing technology. 因子中的两个(平均和分布)是基于对于整个目标区域(ROI)的分析。 The two factors (average and distribution) are based on the entire target area (ROI) analysis. 其它2个因子(斑点(BLOBS)和时域偏移(TEMPERAL)是基于确认组织的氧合模式、其幅值、横向延伸和变化频率的特征分析。为了总结得自全部14 个受试者的数据,我们显示了对于每一个时间步长的作为时间的函数的生理参数平均值(心率和心收縮血压,左侧两个图片)以及超光谱参数(平均值,分布,BLOC以及TEMP,右侧的图片),并连同标准差(图13)。在此,蓝线代表6个对照受试者,并且黑线代表8个出血受试者。 如果我们使用140的心率(人〜110)作为休克的衡量标准,则我们看到在第1次出血后50分钟处见到该事件。如果我们使用70的心脏收縮血压(人〜100)作为休克的衡量标准,则我们在第1次出血后35分钟处见到该事件。利用大于1的超光谱休克指标(HSSI),在第1次出血中的5分钟中指明了明显出血。为了避免比较对于阈值的依赖性,我们构建了受试者工作特性曲线(ROC),其估计通过三个参数:心率、心脏收縮血压以及HSSI确认休克的灵敏度和特异性(图14)。战场超光谱或者多光谱成像可用作小型便携式非侵入监测设备,由急救者用于战场或者用于急救室环境。急救者从病人获取超光谱或者多光谱数据。内建在设备中的软件为急救者提供对于病人状况的评估,包括病人进入休克状态的可能性以及任何对于可能的后果的有用的指示。此信息被急救者用于确定需要稳定病人的护理的合适水平。'在一个示例性实施例中,用于同时收集和积分可见光和近红外MHSI数据两者的战场/急救者系统被构建在耐震的外壳中。可见光和NIR系统分别由三个功能模块组成:光谱成像仪(SI)、支持控制器和功率模块(CPM)以及控制和数据获取计算机(CDAC)。光谱成像仪由可见光和NIR液晶可调谐滤波器(LCTF)以及互补金属氧化物半导体(CMOS)可见光和NIR成像传感器组成,并且装配有微距镜头。优选地,LCTF具有9nm、更优选地8nm、最优选地7nm的带宽。通过改变LCTF两端的电压,可以改变允许通过LCTF进入摄像机的光的波长。系统的焦平面被限定在两个正交的激光定位器的相交点处。成像传感器由1280像素X 1024 像素构成。系统优选具有约12英寸的工作焦距,约7cmX6cm的视场,对应于约60微米的分辨率。在另一个实施例中,仅仅使用可见光。在另一个实施例中,仅仅使用NIR。在另一个实施例中,通过简化的滤波系统收集可见光以及LCTF和单个或若干个NIR带。 The other two factors (spot (BLOBS) and time-domain offset (TEMPERAL) is based on the confirmation tissue oxygenation mode, the amplitude, frequency characteristics extend laterally and change analysis. To summarize from all 14 subjects data, we show that for each time step of physiological parameters as a function of the average time (systolic blood pressure, heart rate and heart, the left two pictures) and hyper-spectral parameters (mean, distribution, BLOC and TEMP, right side the picture), and standard deviation (Figure 13). In conjunction with this, the blue line represents the six control subjects, and the black line represents the eight subjects bleeding. If we use 140 HR (human ~110) as shock The measure, then we see after the first 50 minutes of the bleeding to see the event. If we use 70, systolic blood pressure (~ 100 people) as a measure of shock, then we in the 1st bleeding after 35 minutes at the event to see using hyperspectral shock index greater than 1 (HSSI), indicating a significant bleeding in the 1st hemorrhage five minutes in order to avoid the dependence of the threshold for comparison, we constructed a receiver operating characteristic curve (ROC), which is estimated by three parameters: heart rate, systolic blood pressure and HSSI confirm shock sensitivity and specificity (Figure 14) battlefield hyperspectral or multispectral imaging as a small portable non-invasive monitoring devices by. first aid for war or for the emergency room environment. Emergency patients who obtain from hyperspectral or multispectral data. Built-in device software provides for the patient's condition is assessed as aid, including the possibility of the patient into shock, and any useful indication for the possible consequences. This information is used to determine the need for stability rescuers appropriate level of patient care. "In an exemplary embodiment, both for data collection and integration of visible and near-infrared MHSI battlefield / first aid system is constructed in ruggedized housing visible and NIR systems are composed of three functional modules: spectral imager (SI), support controller and power module (CPM) and the control and data acquisition computer (CDAC ). spectral imager by the visible and NIR liquid crystal tunable filter (LCTF) and complementary metal oxide semiconductor (CMOS) Visible and NIR imaging sensors, and is equipped with a macro lens. Preferably, LCTF have 9nm, more preferably 8nm, most preferably 7nm bandwidth by changing the voltage across the LCTF, can be allowed to change the wavelength of light entering through the LCTF camera. focal plane of the system is limited to the point of intersection of the two laser locator orthogonal imaging sensor by the 1280 pixels X 1024 pixels. system preferably has a focal length of about 12 inches of work, the field of view of about 7cmX6cm, which corresponds to a resolution of about 60 microns. In another embodiment, only visible light is used. In another embodiment, using only the NIR. In another embodiment, the collection and LCTF visible and NIR with a single or several filtering system by simplifying. 使用能量高效的发光二极管(LED)照明组织表面。 Using energy-efficient light-emitting diode (LED) illuminating the tissue surface. 优选地,8个, 更优选地,6个,最优选地,4个可见光LED被用于输送1.8W的宽带的光(其优选地300 — 970nm,更优选地,400 — 850nm,更优选地,450 — 800nm,更优选地,450 — 750nm,最优选地,450 — 720nm)。 Preferably, eight, more preferably 6, most preferably 4 to be used to deliver visible light LED 1.8W broadband light (which is preferably 300 - 970nm, and more preferably, 400 - 850nm, and more preferably , 450 - 800nm, and more preferably, 450 - 750nm, and most preferably, 450 - 720nm). 在740、 780、 810和970nm处的带宽为30nm的NIR发射器被用于输送5w的宽带NIR光(720 — 830nm和945 — 1000nm)。 Broadband NIR light at 740, 780, 810 and 970nm at the bandwidth of 30nm of NIR emitter is used to deliver 5w of (720 - 830nm and 945 - 1000nm). 一个超光谱立方体由25个可见光和25个NIR图像组成。 A hyperspectral cube of 25 and 25 NIR visible image composition. 每一个图像的积分时间被调节,使得图像中的最亮的区域填充CCD的完全阱容量的约80%。 Integration time for each image is adjusted so that the image of the brightest area fills about 80% CCD fully well capacity. 在1分钟内,收集1个完整的光谱数据立方体。 Within 1 minute, to collect a complete spectrum data cube. 另一个实施例使用诸如太阳光的环境光,或者单独使用环境光或者使用补充有诸如闪光的另一个独立光源的环境光。 Another embodiment uses ambient light sunlight, either alone or with supplements such as ambient light ambient light such as flash another independent source. 在此实施例中,由可以测量闪光输出和/或环境光的系统进行自动校准,进行校准,或者指令被提供给操作者来进行对系统的调节。 In this embodiment, the flash output can be measured and / or ambient light system for automatic calibration, calibration, or instruction is provided to the operator to adjust the system. 然后利用Beer法则算法,通过将样品数据相对于从空白参比标准获得的数据定比,将数据转化为光学密度单位。 Then use Beer's law algorithm, the sample data with respect to data obtained from a blank reference standard fixed ratio, the data is converted to an optical density units. 以电子格式获取参比氧合血红素和脱氧血红素光谱。 Get reference oxyhemoglobin and deoxyhemoglobin spectrum in electronic format. 然后对于图像立方体中的每一个光谱进行氧合血红素、脱氧血红素、偏移和斜率项的四项线性回归拟合。 Then, for each image cube spectrum oxyhemoglobin, deoxyhemoglobin four linear regression, offset and slope term fit. 然后,使用回归系数来计算图像立方体中的每一光谱的相对氧饱和度百分比:SHsi02 = OxyHb/(OxyHb + DeoxyHb) * 100 其中,OxyHb为氧合血红素的拟合系数,DeoxyHb是脱氧血红素的拟合系数,其是由线性回归得到的。 Then, use the regression coefficients to calculate the relative percentage of oxygen saturation of each spectral image cube: SHsi02 = OxyHb / (OxyHb + DeoxyHb) * 100 where, OxyHb is fit coefficients of oxyhemoglobin, DeoxyHb is deoxyhemoglobin The fit factor, which is obtained by the linear regression. 然后,通过估计氧合血红素和脱氧血红素、总血红素以及血红素氧饱和度的水平,评估休克状态。 Then, by estimating the oxyhemoglobin and deoxyhemoglobin, total hemoglobin and hemoglobin oxygen saturation level, assessing state of shock. 在氧合中观察到空间分布或者色斑图案还可以用于精细分类区别特性。 Or stain observed spatial distribution pattern can also be used for fine classification difference in characteristics oxygenation. 通过观察色斑图案随时间变化的快速程度可以进行额外的精细化。 By observing the stain patterns change over time how quickly can perform additional fine. 在一个示例性实施例中,MHSI可以被用于即使在受害者由于受害者穿着防护服而难以接触的情况下在受到化学或者生物作用期间监测受试者。 In one exemplary embodiment, MHSI can be used to monitor a subject, even in the case where the victim since the victim wearing protective clothing and hard to reach by chemical or biological effect in the period. 图15所示,可以直接透过防护目镜获取脸的超光谱图像。 Figure 15, you can obtain hyperspectral image directly through the face of the anti-goggles. 体温下降四个动物(体重36.2 0.45 kg)被用于在超光谱图像上评估全身体温下降的效应。 The temperature drops four animals (body weight 36.2 0.45 kg) were used in the hyperspectral image evaluation of the effect of systemic hypothermia. 这些动物经过与出血研究中的那些相似的手术准备。 These animals through research and bleeding similar to those prepared for surgery. 在获取基线数据之后,通过如下操作将动物持续地冷却1小时40分钟:将其放置在两个设置在4'C下的冷却毯之间,之后马上用填充冰的塑料袋覆盖头、颈、腋窝和驱干。 After obtaining baseline data, through the following animals are continuously cooled for 1 hour and 40 minutes: it is placed between two settings in 4'C under cooling blankets, immediately after covering the head and neck with a plastic bag filled with ice, armpits and torso. 在3个动物中,目标核心温度为3rc。 In three animals, the target core temperature is 3rc. 冷却的持续时间接近针对出血方案所述的3个相继的出血和观察时间段的持续时间。 Close for the duration of the cooling duration three successive observation period bleeding and bleeding program said. 为了避免使得核心温度降低到3rC以下, 一旦核心温度达到33C,就将毯和室温分别设定为42。 In order to avoid making the core temperature down to 3rC less, once the core temperature reaches 33 C, will blanket and room temperature are set to 42. C和3(TC。然后去除冰袋,添加Bair Hugger加温毯。进行再加温直至达到基线核心温度值。通过肺动脉导管和直肠温度探针监测体温。利用热电偶在两个后肢上监测区域皮肤温度。因为皮肤s舰02在低至3rc的核心温度下不表现出变化。所以第4个动物被进一步冷却到22'C,而不进行再加温。在其它优选实施例中,可以利用标准分类方法(诸如区别分析或者分类树)来确定休克评估。可以利用由摄像机收集的漫反射信号(在转换成光学密度单位之前或者之后)开始分析。在分析之前,该方法还可以使用主分量分析或者某些其它用于数据简化的手段。本发明提供超光谱/多光谱成像系统,其表明反映全身生理学的变化的局部组织变化,这里所述变化是在出血性休克和复生期间的皮肤氧合和S服02的变化。其它的HSI的优选用途包括但不限于,S腦02的宏观分布、在大鼠的乳癌切除过程中肿瘤的原位检测,在整形手术和烧伤之后的组织可存活性确定,外围动脉疾病病人和糖尿病人的跛足和足部溃疡,以及分别对于在猪和人的低体负压(LBNP)下的循环虚脱和血量减少代谢失调的应用。在整个申请中,我们描述了超光谱成像,但是可以类似地采用多光谱成像,并且当提及MHSI或者HSI时,包括了超光谱成像或者多光谱成虽然这些方法和仪器被描述用于医疗和生理评估,但是其可以被类似地用于其它应用领域,包括体内和体外生物、法医、环境、地质、化学、 天文和其它领域。根据本文所公开的对发明的说明和实施,本发明的其它实施例和用途对于本领域技术人员将是明显的。本文引用的所有参考文献,包括所有出版物、美国和外国专利和专利申请通过引用被明确和全文包括于此,包括2005年11月29日提交的美国专利申请"Medical Hyperspectral Imaging for Evaluation ofTissue and Tumor"(还没有分配申请号)。说明书和实例是示例性的,本发明的真正范围和精神仅仅由所附权利要求限定。 C and 3 (TC. Then removing ice, add the Bair Hugger warming blanket. Were re-warmed until it reaches the baseline core temperature through a pulmonary artery catheter and rectal temperature probes to monitor temperature using a thermocouple to monitor areas of the skin on both hind legs temperature because the skin s ship 02 at low 3rc core temperature does not exhibit changes so the first four animals were further cooled to 22'C, without plus temperature. In other preferred embodiments, using standard Classification methods (such as discriminant analysis or classification trees) to determine the shock evaluation. You can use diffuse signals collected by a camera (in converted before or after the optical density units) start the analysis. Prior to analysis, the method can also be used principal component analysis or some other means for data reduction. The present invention provides hyperspectral / multispectral imaging system, which indicates that the local tissue changes reflect changes in the physiology of the body, where the change in skin oxygenation during hemorrhagic shock and resuscitation of S and change clothes 02. Other preferred uses include, but are not limited to, HSI, macroscopic brain distribution of S 02, the in situ detection of breast cancer in rats in the process of tumor resection, and after plastic surgery and burns tissue viability determination, peripheral arterial disease and diabetes patients lameness and foot ulcers, as well as separately for circulation in pigs and human low body negative pressure (LBNP) collapse under metabolic disorders and blood volume reduction applications. Throughout this application, We describe the hyperspectral imaging, but may be similarly multi-spectral imaging, and when referring to MHSI or HSI, including a multi-spectral or hyperspectral imaging to While these methods and apparatus are described for use in medical and physiological assessment, but it is It may be similarly used in other applications, including in vivo and in vitro biological, forensic, environmental, geology, chemistry, astronomy, and other fields. According to the disclosed embodiments of the invention described herein and that other embodiments of the present invention and use of the Those skilled in the art will be apparent. All references cited herein, including all publications, US and foreign patents and patent applications are expressly incorporated by reference herein and include full text, including the United States Patent Application November 29, 2005 filed "Medical Hyperspectral Imaging for Evaluation ofTissue and Tumor" (not yet assigned application number) specification and examples are exemplary, with a true scope and spirit of the present invention is limited only by the appended claims.

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