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Non-invasive Assessment of Microvascular and Endothelial Function

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Assessing Hand Perfusion With Eulerian Video Magnification and Waveform Extraction.

Shihab Rahman¹, Aygul Iskandarova², Max E Horowitz³

¹Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD.

The Journal of Hand Surgery

|August 13, 2022

Summary

Eulerian Video Magnification (EVM) with waveform extraction improves the assessment of hand and finger perfusion, especially in darker skin tones. This video-based method enhances accuracy for identifying ischemia, aiding in critical injury triage.

Keywords:

Ischemia perfusion skin pigmentation trauma triage upper extremity

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Area of Science:

Biomedical Engineering
Medical Imaging
Vascular Surgery

Background:

Current perfusion monitoring for upper extremity injuries has limitations, particularly for individuals with darker skin tones.
Accurate and timely triage is crucial for managing these injuries.

Purpose of the Study:

To evaluate a Eulerian Video Magnification (EVM) algorithm combined with color channel waveform extraction for video-based measurement of hand and finger perfusion.
To assess the effectiveness of this technique across various skin tones.

Main Methods:

Videos of 10 participants (Fitzpatrick skin types III-VI) were recorded during normal perfusion and induced ischemia.
Videos were processed using EVM with color channel waveform extraction.
Surgeons assessed videos presented in unprocessed, EVM-processed, and EVM+waveform formats.

Main Results:

The EVM+waveform method showed significantly higher accuracy and agreement in identifying ischemia compared to unprocessed or EVM-processed videos.
This improvement was consistent across all tested skin pigmentations.
Surveys completed by 25 providers indicated the effectiveness of the EVM+waveform approach.

Conclusions:

Video-based EVM processing with waveform extraction enhances surgeons' ability to detect finger ischemia across all skin types.
This technology shows promise for improving triage, vascular assessment, and telemedicine applications in upper extremity injuries.