Multimodal optical diagnostics of the microhaemodynamics in upper and lower limbs

The introduction of optical non-invasive diagnostic methods into clinical practice can substantially advance in the detection of early microcirculatory disorders in patients with different diseases. This paper is devoted to the development and application of the optical non-invasive diagnostic approach for the detection and evaluation of the severity of microcirculatory and metabolic disorders in rheumatic diseases and diabetes mellitus. The proposed methods include the joint use of laser Doppler flowmetry, absorption spectroscopy and fluorescence spectroscopy in combination with functional tests. This technique showed the high diagnostic importance for the detection of disturbances in peripheral microhaemodynamics. These methods have been successfully tested as additional diagnostic techniques in the field of rheumatology and endocrinology. The sensitivity and specificity of the proposed diagnostic procedures have been evaluated.<br/

Optical non-invasive diagnostics of microcirculatory-tissue systems of the human body: questions of metrological and instrumentation provision

Optical techniques are one of the most promising non-invasive technologies for the diagnosis of medical conditions. This work is devoted to the current state of the optical non-invasive diagnostics (OND), especially about instrumentation as well as methodological and metrological provision for this technology. In some details Laser Doppler Flowmetry (LDF) and Fluorescence Spectroscopy (FS) diagnostics methods are considered. The main conclusion is that it is necessary to solve the problems of metrological support OND devices of these types. It is also important to develop a methodology based on diagnostic criteria obtained from a relationship between a number of OND methods and others

Combined use of laser Doppler flowmetry and skin thermometry for functional diagnostics of intradermal finger vessels

We introduce a noninvasive diagnostic approach for functional monitoring of blood microflows in capillaries and thermoregulatory vessels within the skin. The measuring system is based on the combined use of laser Doppler flowmetry and skin contact thermometry. The obtained results suggest that monitoring of blood microcirculation during the occlusion, performed in conjunction with the skin temperature measurements in the thermally stabilized medium, has a great potential for quantitative assessment of angiospatic dysfunctions of the peripheral blood vessels. The indices of blood flow reserve and temperature response were measured and used as the primarily parameters of the functional diagnostics of the peripheral vessels of skin. Utilizing these parameters, a simple phenomenological model has been suggested to identify patients with angiospastic violations in the vascular system

Evaluation of microvascular disturbances in rheumatic diseases by analysis of skin blood flow oscillations

Laser Doppler flowmetry (LDF), tissue reflectance oximetry (TRO) and pulse oximetry (PO) and cold pressor test (CPT) were used to assess the microcirculation parameters and the activation of regulatory mechanisms. LDF and TRO samples wavelet transform in the frequency bands 0.01-2 Hz was used to evaluate microvascular disturbances in rheumatic diseases and to assess the vascular involvement in the pathological process. The spectral components of LDF and TRO signals associated with endothelial, adrenergic, intrinsic smooth muscle, respiratory and cardiac activities were analyzed. Significant difference between healthy and rheumatology subjects was identified in perfusion parameters. Spectral analysis of the LDF signal revealed significant difference between two group of high (<0.1 Hz) frequency pulsations. Based on the analysed of the perfusion and amplitudes oscillation in the frequency band the decision rule for detection microvascular disturbances were synthesized. The perfusion parameter and amplitude oscillation associated with cardiac activities included in the decision rule. Based on the measured parameters and the result of wavelet transform LDF- and TRO-signals the parameters for detection of complications associated with microvascular disturbances and their possible causes were proposed

Pilot studies of age-related changes in blood perfusion in two different types of skin

Laser Doppler flowmetry (LDF) was utilized to assess age-related changes in the blood microcirculation at the skin sites with different morphology and regulation. The LDF signals obtained from the glabrous skin of the middle finger pad and nonglabrous skin on the dorsal wrist surface were analyzed. Statistically higher baseline perfusion was observed in the zone with glabrous skin in the older group of volunteers compared to younger participants. Observed site-specific and age-related differences in perfusion can be used in the future experimental design for the studies of the blood microcirculation system in patients with different pathologies

Laser doppler spectrum decomposition applied in diagnostics of microcirculatory disturbances

Laser Doppler flowmetry (LDF) is widely used to study blood microcirculation in the skin. However, during tradition signal processing based on the integral estimations of the power spectrum of detector photocurrent, the significant part of the information about the skin blood ow is lost. In this study, we propose to analyse the distribution of the blood perfusion over the Doppler shift frequencies, which correlate with the RBC velocity. This approach provides localisation of the blood ow oscillations in different subranges of the Doppler shift. The method applied together with the wavelet analysis has been tested in healthy volunteers and patients with psoriasis on the unaffected surface of the skin. It was revealed, that the significant difference in the amplitude of myogenic oscillations is allocated in the region of the low frequency Doppler shift (1-200 Hz). This frequency region can be associated with the signal from slow components of the skin microcirculation, that can point out on a different state of the lymphatic system of the skin in psoriasis

Fibre-optic probe for fluorescence diagnostics with blood influence compensation

To minimise the influence of blood content on the fluorescence measurements in vivo, a fibre optical probe combining fluorescence and diffuse reflectance measurements was developed. For the inverse solution of the blood content recovery, a set of neural networks trained by the Monte Carlo generated learning set was used. An approach of fluorescence measurements triggered by simultaneous real-time measurements of blood content in living tissue during moderate changes in contact pressure of the optic probe is proposed. The method allows one to decrease the necessary pressure on the probe as well as increase the repeatability of the measurements. The developed approach was verified in a series of experiments on volunteers with fluorescence excitation at 365 nm and 450 nm. The proposed technology is of particular interest in the development of new fluorescence-based optical biopsy systems

The development of attenuation compensation models of fluorescence spectroscopy signals

This study examines the effect of blood absorption on the endogenous fluorescence signal intensity of biological tissues. Experimental studies were conducted to identify these effects. To register the fluorescence intensity, the fluorescence spectroscopy method was employed. The intensity of the blood flow was measured by laser Doppler flowmetry. We proposed one possible implementation of the Monte Carlo method for the theoretical analysis of the effect of blood on the fluorescence signals. The simulation is constructed as a four-layer skin optical model based on the known optical parameters of the skin with different levels of blood supply. With the help of the simulation, we demonstrate how the level of blood supply can affect the appearance of the fluorescence spectra. In addition, to describe the properties of biological tissue, which may affect the fluorescence spectra, we turned to the method of diffuse reflectance spectroscopy (DRS). Using the spectral data provided by the DRS, the tissue attenuation effect can be extracted and used to correct the fluorescence spectra

Wearable laser Doppler sensors for evaluating the nutritive and shunt blood flow

This study is devoted to the trials of wearable diagnostic system that implements the laser Doppler flowmetry technique to analyse the blood microcirculation. We do preliminary test with involvement of limited group of healthy volunteers of different age and in patients with type 2 diabetes. During the series of measurements, the microcirculation parameters was measured for 10 minutes in the palmar surfaces of the big toes and in the inner sides of the upper thirds of the shins. A statistically significant differences was found in bypass index, nutritive and shunt blood ow in shins between older group of volunteers and patients' group as well as in shunt blood flow in fingers between younger and older groups of volunteers

Wearable sensor system for multipoint measurements of blood perfusion: pilot studies in patients with diabetes mellitus

The growing interest in the development of new wearable electronic devices for mobile healthcare provides great opportunities for the development of methods for assessing blood perfusion in this direction. Laser Doppler flowmetry (LDF) is one of the promising methods. A fine analysis of capillary blood ow structure and rhythm in the time and frequency domains, coupled with a new possibility of round-the-clock monitoring can provide valuable diagnostic information about the state of microvascular blood ow. In this study, wearable implementation of laser Doppler flowmetry was utilised for microcirculatory function assessment in patients with diabetes and healthy controls of two distinct age groups. Four wearable laser Doppler flowmetry monitors were used for the analysis of blood microcirculation. Thirty-seven healthy volunteers and 18 patients with type 2 diabetes mellitus participated in the study. The results of the studies have shown that the average perfusion differs between healthy volunteers of distinct age groups and between healthy volunteers of the younger age group and patients with diabetes mellitus. It was noted that the average level of perfusion measured on the wrist in the two groups of healthy volunteers has no statistically significant differences found in similar measurements on the fingertips. The wearable implementation of LDF can become a truly new diagnostic interface to monitor cardiovascular parameters, which could be of interest for diagnostics of conditions associated with microvascular disorders