Method and apparatus for determining the motility of a region in the human body

• US 5,247,938 A
• Filed: 01/11/1990
• Issued: 09/28/1993
• Est. Priority Date: 01/11/1990
• Status: Expired due to Fees

• Current Assignee: Board of Regents of The University of Washington (University of Washington)
• Original Assignee: University of Washington
• Inventors: Kimmey, Michael B., Jiranek, Geoffrey C., Schuffler, Michael D., Martin, Roy W., Silverstein, Fred E., Proctor, Andrew H.
• Primary Examiner(s): Jaworski, Francis
• Assistant Examiner(s): Pontius, Kevin
• Application Number:
  US07/463,548
• Time in Patent Office: 1,356 Days
• Field of Search: 128/662.06, 128/662.03, 128/662.04, 128/660.03, 128/713, 128/631, 128/748, 128/661.09, 128/660.03, 128/662.06
• US Class Current: 600/459
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 1/2736 Gastroscopes
• CPC Class Codes: A61B 1/31 for the rectum, e.g. proctoscopes, sigmoidoscopes , colonoscopes
• CPC Class Codes: A61B 5/036 by means introduced into body tracts A61B5/032 and A61B5/035 take precedence
• CPC Class Codes: A61B 5/07 Endoradiosondes
• CPC Class Codes: A61B 5/076 Permanent implantations telemetry using implanted circuitry A61B5/0031; implanted stimulators for therapy A61N1/3605, A61N1/362, A61N1/372
• CPC Class Codes: A61B 5/4255 Intestines, colon or appendix
• CPC Class Codes: A61B 5/4519 Muscles A61B5/389, A61B5/224 take precedence
• CPC Class Codes: A61B 5/6834 using vacuum
• CPC Class Codes: A61B 8/0858 involving measuring tissue layers, e.g. skin, interfaces
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 8/445 Details of catheter construction

Abstract

Devices are described which can be used to study the physiological function of the intestinal wall. These devices include an ultrasonic transducer that can be attached to a region of the intestinal wall. The transducer interrogates the wall and echoes are obtained from the different wall layers. The echoes are processed to produce an M-mode display of the wall. This allows monitoring how the wall changes with time. For example, as the wall contracts the muscle layer thickens and this action may be observed with the device. Other sensors and electrodes can be combined with this probe to correlate various physiological action. Finally, several such probes can be combined into a common introducible probe but which will monitor several regions along the intestinal wall. The major advantage of the disclosed device is that it provides a measurement of intestinal motility previously unattainable and it is introducible by endoscopy. This makes it a suitable tool for studying patient disease.

Claims

1. An apparatus for simultaneously measuring thickness of a wall of the digestive tract and the local pressure within the digestive tract of a living body, comprising:

an ultrasonic transducer within a probe that is adapted to be attached in a fixed position to said wall within said living body;

a transmitter means for causing said transducer to emit a plurality of ultrasonic pulses into said wall at a selected rate;

a receiver means for receiving electronic signals from said transducer corresponding to ultrasonic energy reflected from said wall, the round trip time for the ultrasonic energy reflected from said wall being indicative of the thickness of the wall for the reflected ultrasonic energy;

a pressure sensor means adjacent said transducer for measuring the gas pressure in said digestive tract simultaneously with said transducer transmitting ultrasonic energy into walls of said digestive tract;

a flexible coupling means connecting said transmitter means to said transducer for permitting said transducer to move freely with respect to said transmitter means to permit movement of said wall to which said transducer is adapted to be attached; and

a display means for displaying said received electronic signals.

2. The apparatus according to claim 1, further including a plurality of said probes having respective transducers spaced from each other when attached along said lumen wall, said transmitter means causing each transducer within said probes to emit ultrasonic energy, and said display means providing an individual display for signals received by each of said transducers.

3. The apparatus according to claim 1 wherein said transmitter means emits said ultrasonic pulses at a preselected repetition rate over a period greater than one hour and said display means provides a printed record of reflections from said pulses over said period.

4. The apparatus according to claim 1 wherein said pressure sensor is within said probe.

5. An apparatus for measuring thickness of a wall of the digestive tract of a living body, comprising:

an ultrasonic transducer within a probe that is adapted to be attached in a fixed position to said wall of the digestive tract;

a transmitter means for causing said transducer to emit a plurality of ultrasonic pulses into said wall at a selected rate;

a receiver means for receiving electronic signals from said transducer corresponding to ultrasonic energy reflected from said wall, the round trip time for the ultrasonic energy reflected from said wall being indicative of the thickness of the wall for the reflected ultrasonic energy;

a muscle tension sensor means adjacent to said transducer for measuring the tension in said muscle adjacent to said transducer;

a flexible coupling means connecting said transmitter means to said transducer for permitting said transducer to move freely with respect to said transmitter means to permit movement of said wall to which said transducer is adapted to be attached; and

a display means for displaying said received electronic signals.

6. An apparatus for measuring movement of a portion of a living body comprising:

an ultrasonic transducer within a probe that is adapted to be attached in a fixed position to said living body;

a transmitter means for causing said transducer to emit a plurality of ultrasonic pulses into said living body at a selected along a given scan line direction rate;

a receiver means for receiving electronic signals from said transducer corresponding to ultrasonic energy reflected from within said body;

a data storage means for storing data corresponding to said electronic signals, said data being stored in scan lines, one scan line storing data for each pulse transmitted, the stored data being representative of movement of a portion of the living body;

a variable data reading means for reading only said scan lines which are temporally separate from each other by a predetermined variable number of scan lines;

a display means for displaying said scan lines which have been read by said variable data reading means.

7. The apparatus according to claim 6 wherein said number is fifty.

8. The apparatus according to claim 6 wherein said number is ten.

9. The method of studying movement of a wall within a living body, comprising:

attaching a plurality of ultrasonic transducer probes to said wall within said living body, said transducer probes being spaced from each other along said wall of said living body;

coupling the plurality of probes to each other with a flexible coupling, each of the probes including an ultrasonic transducer;

transmitting ultrasonic energy into said wall at a selected frequency for each of said probes within the plurality of probes;

receiving ultrasonic energy reflected from individual regions within said wall, by each probe of said plurality, said frequency being selected to image individual regions within said wall;

repeating said transmitting and receiving steps a plurality of times over a selected interval of time; and

producing a plot of individual regions within said wall over time based on the ultrasonic energy reflected from said individual regions over time, at which each probe within said plurality of probes is positioned.

10. The apparatus according to claim 9, further including a data storage means for storing data corresponding to said electronic signals, said data being stored in scan lines, one scan line storing data from two pluses, the data from the pulses being interdigitated in the scan line.

11. The method according to claim 9, further including the steps of:

coupling a plurality of probes to each other with a flexible coupling, each of said probes including an ultrasonic transducer;

attaching said plurality of transducer probes to said wall, said probes being spaced from each other along said wall;

repeating said transmitting and said receiving steps for said plurality of transducers; and

producing individual plots for each transducer over time.

12. The method according to claim 9 wherein said wall is a wall of the digestive tract within a living body, and further including the steps of:

placing some food within said digestive tract; and

repeating said transmitting and receiving step while said food is being digested.

13. The method according to claim 9 wherein said wall is the wall of a lumen within the human body, further including the step of measuring the local pressure within said lumen simultaneously with performing said transmitting and receiving steps.

14. An apparatus for determining the motility of a region of a living body, comprising:

a plurality of probes, each having an ultrasonic transducer, said probes being adapted to be attached to said region;

a transmitter means for providing an electrical signal to said transducers, causing them to emit an ultrasonic pulse;

a receiver means for receiving electrical signals from said transducers representative of the ultrasonic energy reflected from said region;

a multiplexer means for selectively coupling said transmitter means to one of said plurality of said transducers;

a plotting means for producing a line in a plot corresponding to the received signals;

a line selection means coupled to said plotting means for selectively providing to said plotting means some of said received signals, and blocking some of said signals from said plotting means, such that said plot includes lines for some of said received signals and does not include lines for other of said received signals; and

a clock means coupled to said transmitter means for causing said transmitter means to emit said electrical signals at selected intervals.

15. The apparatus according to claim 14 wherein said probes are coupled to each other with a flexible coupling to permit said transducers to freely move relative to each other as said region of the living body moves.

16. The apparatus according to claim 14 wherein said line selection means includes means for causing every other one of said lines to be plotted and every other one of said lines to be blocked and not be plotted in said plot.

17. The apparatus according to claim 14 wherein said line selection means includes means for providing every tenth line to said plotting means and blocks nine out of ten lines from entering said plotting means.

18. The apparatus according to claim 14 wherein said selection means includes a video display monitor.

19. A method of simultaneously measuring movement of walls of the digestive tract within an esophagus and within a large intestine of a living body comprising:

attaching an ultrasonic transducer probe to a wall of said digestive tract within said esophagus;

attaching an ultrasonic transducer probe to a wall of said digestive tract within said intestine;

simultaneously transmitting ultrasonic energy into said esophagus wall and said intestine wall via respective transducers;

receiving the transmitted ultrasonic energy that is reflected back from the esophagus wall and the intestine wall respective via respective transducers;

repeating said transmitting and receiving steps a plurality of times over a selected interval of time; and

producing a plot of the change in thickness of regions within said respective walls over time based on the ultrasonic energy reflected from said regions over time.

20. The method of studying movement of a wall within a lumen of a living body, comprising:

attaching an ultrasonic transducer probe to said wall within said living body;

transmitting ultrasonic energy into said wall;

receiving ultrasonic energy reflected from regions within said wall;

repeating said transmitting and receiving steps a plurality of times over a selected interval of time;

producing a plot of regions within said wall over time based on the ultrasonic energy reflected from said regions over time; and

measuring the local pressure within said lumen simultaneously with performing said transmitting and receiving steps.

21. The method of studying movement of a wall within a living body, comprising:

attaching an ultrasonic transducer probe to said wall within said living body using a rigid rod coupled to said probe, said transducer probe being connected to a control circuit with a coupling member;

removing said rigid rod from being coupled to said transducer probe after said transducer probe is attached to said wall to render said coupling flexible between said transducer probe and said control circuit;

transmitting ultrasonic energy into said wall;

receiving ultrasonic energy reflected from regions within said wall;

repeating said transmitting and receiving steps a plurality of times over a selected interval of time; and

producing a plot of regions within said wall over time based on the ultrasonic energy reflected from said regions over time.