Non invasive identification of intestinal ischemia from measurement of basic electrical rhythm of intestinal smooth muscle electrical activity using a magnetometer

• US 5,771,894 A
• Filed: 04/28/1997
• Issued: 06/30/1998
• Est. Priority Date: 06/05/1995
• Status: Expired due to Fees

• Current Assignee: Vanderbilt University
• Original Assignee: Vanderbilt University
• Inventors: Wikswo, John P. Jr., Richards, William O., Bradshaw, Leonard A., Golzarian, Javad, Staton, Daniel J.
• Primary Examiner(s): Smith, Ruth S.
• Application Number:
  US08/847,838
• Time in Patent Office: 428 Days
• Field of Search: 128/653.1, 128/691, 324/244, 324/248
• US Class Current: 600/409
• CPC Class Codes: A61B 5/242 Detecting biomagnetic fields, e.g. magnetic fields produced by bioelectric currents
• CPC Class Codes: A61B 5/42 Detecting, measuring or recording for evaluating the gastrointestinal, the endocrine or the exocrine systems A61B1/00, A61B5/4857, A61B5/486, A61B5/4866, A61B5/4869 take precedence
• CPC Class Codes: A61B 5/4255 Intestines, colon or appendix

Abstract

Intestinal ischemia is diagnosed non-invasively by scanning the abdomen externally with a SQUID magnetometer which measures the magnetic field produced by smooth muscle electrical activity. These measurements are processed to determine the basic electrical rhythm (BER) frequency at various locations along the intestine. A nominal value for the BER frequency is established at each location, and if the measured value falls below the associated nominal value by more than a predetermined margin, ischemia at that location is indicated. Ischemia is further indicated by an interval of arrhythmia in which the BER frequency increases to a range of about 24-180 cpm or at least about twice the nominal value. The BER frequency values are presented on a graphic display which provides an indication of the nominal value at an affected location from the gradient of the measured values at adjacent normal locations. Also, a gradual reduction in the local BER frequency at a particular location is an indication of progressive ischemia, while an absence of BER activity in a section of intestine indicates necrosis.

Claims

1. A non-invasive method of diagnosing intestinal ischemia from a magnetic field produced by smooth muscle electrical activity in an intestine in vivo within an abdomen, said method comprising the steps of:

measuring the magnetic field produced by said smooth muscle electrical activity in said intestine at at least one location external to said abdomen;

determining a measured value of local Basic Electrical Rhythm (BER) frequency from said magnetic field at said at least one location external to said abdomen;

establishing a nominal value for said local BER frequency at said at least one location; and

identifying intestinal ischemia at said at least one location when said measured value of local BER frequency at said at least one location differs from said nominal value for said local BER frequency by a predetermined margin and is accompanied by an interval of arrhythmia.

2. The method of claim 1 wherein intestinal ischemia is identified when said measured value of local BER frequency at said at least one location is at least about 20% below said nominal value and is accompanied by said interval of arrhythmia.

3. The method of claim 1 wherein said arrhythmia has a frequency of at least about 24 to about 180 cpm.

4. The method of claim 1 wherein said arrhythmia has a frequency of at least about twice said nominal BER frequency.

5. The method of claim 1 wherein said step of measuring comprises measuring a measured value of local BER frequency for each of a plurality of sections of said abdomen, said step of establishing comprises establishing an associated nominal value for said local BER frequency for each of said plurality of sections of said abdomen, and said step of identifying comprises identifying intestinal ischemia if said measured value of local BER frequency for any of said sections of said abdomen differs from the associated nominal value for said local BER frequency by a predetermined associated margin and is accompanied by said interval of arrhythmia.

6. The method of claim 5 wherein said step of identifying includes generating a display of said measured values of BER frequency for each of said sections of said abdomen.

7. The method of claim 5 wherein said predetermined associated margin is a decrease in the local BER frequency of at least about 20% below said associated nominal value for said local BER frequency.

8. The method of claim 5 wherein ischemia is identified when said measured value of local BER frequency falls below the associated nominal value for BER frequency in one of said sections of said abdomen and is accompanied by said interval of arrhythmia.

9. The method of claim 8 wherein said arrhythmia is an interval wherein said BER frequency increases to at least about twice the associated nominal value of said BER frequency for said section of said abdomen.

10. The method of claim 1 wherein said step of measuring comprises measuring local BER frequency at a plurality of locations generally in succession along at least one portion of said intestine in a direction toward an end of said intestine, wherein establishing nominal values of said BER frequency comprises establishing from said measured values at said plurality of locations generally in succession a general trend in said local BER frequencies in said direction toward said end, and wherein identifying ischemia comprises identifying intestinal ischemia at locations at which said measured value of local BER frequency differs from said general trend in local BER frequency by said predetermined margin and is accompanied by said interval of arrhythmia.

11. The method of claim 10 wherein said step of identifying comprises generating a display presenting said measured values of local BER frequency for said plurality of locations generally in succession.

12. The method of claim 10 wherein said step of identifying comprises identifying a location along said at least portion of said intestine as ischemic when the measured value of BER frequency at that location exhibits said arrhythmia.

13. The method of claim 1 wherein said step of measuring local BER frequency comprises measuring local BER frequency for a plurality of sections along said intestine, wherein said step of establishing nominal values comprises establishing a nominal value associated with each of said sections along said intestine from the local measured value of BER frequency for others of said locations, and wherein said step of identifying ischemia comprises identifying sections along said intestine as ischemic when the measured value of local BER frequency for a section differs from the associated nominal value for BER frequency for that section by said predetermined margin and is accompanied by said interval of ischemia.

14. Apparatus for analyzing a magnetic field produced by smooth muscle electrical activity in an intestine in vivo within an abdomen for use in non-invasive diagnosis of intestinal ischemia, said apparatus comprising:

magnetometer means producing detected values of said magnetic field at at least one location across said abdomen;

processing means generating from said detected values of said magnetic field measured values of local basic electrical rhythm (BER) frequency of said smooth muscle electrical activity at said at least one location including values associated with arrhythmia; and

means presenting a representation of said measured values of local BER frequency including said values associated with arrhythmia.

15. The apparatus of claim 14 wherein said magnetometer means comprises a SQUID magnetometer.

16. The apparatus of claim 14 wherein said magnetometer means comprises an array of SQUID magnetometers producing a detected value of said magnetic field at an array of locations across said abdomen, wherein said processing means generates from said array of detected values of said magnetic field, an array of values for a local BER frequency at said plurality of locations, and wherein said means presenting a representation of said measured values of local BER frequency, presents a representation of said measured values of BER frequency at each of said plurality of locations.

17. The apparatus of claim 14 wherein said means presenting a representation of said measured values of BER frequency is responsive to values of BER frequency associated with arrhythmia from about 24 to about 180 cpm.

18. The apparatus of claim 14 wherein said means presenting a representation of said measured values of local BER frequency also provides an indication of a nominal value of said BER frequency.

19. The apparatus of claim 18 wherein said magnetometer means produces a detected value of said magnetic field at an array of locations across said abdomen, wherein said processing means generates a measured value of local BER frequency for each of said array of locations, and wherein said means presenting a representation of said measured values of local BER frequency presents a measured value of said local BER frequency for each of said locations.

20. The apparatus of claim 19 wherein said processing means comprises means generating a measure of dominant values of said local BER frequency at said array of locations, and wherein said means presenting a representation of said measured values of BER frequency generates a display indicating where in said array of locations said dominant values of BER frequency are located.

21. The apparatus of claim 20 wherein said means presenting a representation of said measured values of local BER frequency generates a display with a series of screens with each screen displaying the location in said array of a different one of said dominant BER frequency values.

22. A non-invasive method of diagnosing intestinal ischemia from a magnetic field produced by smooth muscle electrical activity in an intestine in vivo within an abdomen, said method comprising the steps of:

measuring the magnetic field produced by said smooth muscle electrical activity in said intestine at at least one location external to said abdomen;

determining a measured value of local Basic Electrical Rhythm (BER) frequency from said magnetic field at said at least one location external to said abdomen; and

identifying intestinal ischemia at said at least one location when said measured value of said local BER frequency at said at least one location exhibits an interval of arrhythmia.

23. The method of claim 22 wherein said step of identifying intestinal ischemia at said at least one location comprises establishing a nominal value for said local BER frequency at said at least one location and identifying ischemia when said local BER frequency exhibits an interval of arrhythmia in which said BER frequency is at least about twice said nominal value for said local BER frequency.

24. The method of claim 22 wherein said step of identifying intestinal ischemia at said at least one location comprises identifying intestinal ischemia when said measured value of local BER frequency at said one location exhibits an interval of arrhythmia in which said BER frequency is between 24 and 180 cpm.