METHOD FOR DETECTING DISEASE USING HIGH RESOLUTION MANOMETRY, AND APPARATUS THEREOF
A method for detecting disease using a manometry includes obtaining pressure values from each of the plurality of pressure sensors during a pre-set time, obtaining a three-dimensional pressure distribution showing the changes in the pressure values according to location and time by using the time, the pressure values, and locations in which the pressure sensors are disposed within the arbitrary location section, and calculating the volume integral value of the interest location which is predetermined in accordance with the disease, in the three-dimensional pressure distribution.
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This application is a Divisional Application of U.S. patent application Ser. No. 15/310,793 filed on Nov. 14, 2016 under 35 U.S.C. § 120, which is a National Stage Application of PCT International Patent Application No. PCT/KR2015/002761 filed on Mar. 20, 2015, under 35 U.S.C. § 371, which claims priority to Korean Patent Application Nos. 10-2014-0033402 filed on Mar. 21, 2014 and 10-2014-0033403 filed on Mar. 21, 2014, which are all hereby incorporated by reference in their entirety.
BACKGROUNDThe present invention relates to a method for detecting disease using a high resolution manometry, and an apparatus thereof. More particularly, the present invention relates to a method for detecting disease using a high resolution manometry, and an apparatus thereof that uses high resolution manometry having a plurality of pressure sensor or a plurality of impedance electrodes to examine anus rectum disease or esophagus disease.
Rectum and anus performs important physiological function for normal defecation. Due to the function abnormality of rectum and anus, a patient complains of constipation, stool residual feeling, fecal incontinence, and so on.
The methods for verifying the function abnormality of rectum and anus includes colonoscopy, balloon expulsion test, defecography, anus sphincter electromyography, anorectal manometry, and so on. Most represent method testing the function of rectum and anus among them is a anorectal manometry, which is mainly applied to anus sphincter function test and treatment planning for a defecation disorder patient or a perioperative patient of rectum anus area.
A anorectal manometry inserts manometry, which a plurality of pressure sensors are disposed, into anus and obtain pressure value, and determines disease by using the obtained pressure value. In general, a representative value among all sensor values in a manometry is used, or an average value is used, and there is a drawback that an accuracy and reliability of disease determination is deteriorated.
Also, esophagus disease shows aphagopraxia, ptyalorrhea, nausea, and so on, and it is necessary to test esophagus to verify the disease. In case of esophagus movement disease causing aphagopraxia, it is difficult to verify this through upper endoscopy, and it is necessary to perform esophagus internal pressure test, that is to say manometry test. These manometry test is performed by sensors that are arranged at intervals of 5 centimeters in the seventies or eighties to analyze the result value, but a high resolution manometry has been developed in the last decade, in which sensors are arranged at intervals of 1 centimeter dense than that of the conventional art to verify disease.
An impedance test method that is limitedly used to verify a gastroesophageal reflux disease is noticed by an idea that amount of bolus swallowed through esophagus is detected by indirect resistance, and it is attached to a high resolution manometry catheter to be used.
In this connection, a catheter in which a plurality of impedance electrodes are formed in a length direction is inserted into a esophagus in a high resolution impedance manometry, characteristics of bolus is detected based on resistance change, and esophagus disease can be verified by these results. If the amount of transit object in esophagus remains more, the impedance value is lowered, and therefore possibility of esophagus disease is increased.
However, an impedance test method using the high resolution manometry catheter has many limitations in analyzing the result value, decisively does not show accurate objective number, and there was a limitation in a clinical use.
As a back ground art of the present invention, there is a KOREA Patent No. 0816847 (published in 2008 Mar. 2019) and Patent Laid-Open Publication No. 2002-0093860 (2002 Dec. 2016).
The above information disclosed in this Background section is only for enhancement of understanding of the background of the invention and therefore it may contain information that does not form the prior art that is already known in this country to a person of ordinary skill in the art.
SUMMARYThe present invention has been made in an effort to provide a method for detecting disease using a high resolution manometry, and an apparatus thereof having advantages of improving determination efficiency of each disease related to rectum anus or esophagus.
The present invention provides a method for detecting disease using a manometry according to the present invention includes obtaining pressure values from each of the plurality of pressure sensors during a pre-set time, obtaining a three-dimensional pressure distribution showing the changes in the pressure values according to location and time by using the time, the pressure values, and locations in which the pressure sensors are disposed within the arbitrary location section, and calculating the volume integral value of the interest location which is predetermined in accordance with the disease, in the three-dimensional pressure distribution.
Wherein the arbitrary location section includes a first section corresponding to a rectum area and a second section corresponding to an anus area when the manometry is inserted, and in the calculating the volume integral value, when the disease is constipation, the first section is set to the interest location to calculate the volume integral value and when the disease is fecal incontinence, the second section is set to the interest location to calculate the volume integral value.
Also, the method for detecting anus diseases using a manometry in a case that the disease is constipation may further include calculating a ratio of a volume integral value of the first section to the entire volume integral value of the three-dimensional pressure distribution, comparing the calculated ratio with a predetermined threshold value, and determining that there is constipation disease, if the calculated ratio is less than the threshold value.
Also, the method for detecting anus diseases using a manometry in a case that the disease is fecal incontinence may further include comparing a volume integral value of the second section with a predetermined threshold value, and determining that there is fecal incontinence disease, if the volume integral value of the second section is less than the threshold value.
Also, the method for detecting anus diseases using a manometry may further include dividing the arbitrary location section to a first section and a second section within the arbitrary location section according to the predetermined ratio, if the ratio of the first section and the second section is predetermined, and setting an interest section among the first section and the second section.
And, this invention provides an apparatus for detecting anus diseases using a manometry that a plurality of pressure sensors are disposed at determined intervals along an arbitrary location section in a length direction that includes a pressure value obtaining portion that obtaining pressure values from each of the plurality of pressure sensors during a pre-set time, a three-dimensional distribution obtaining portion that obtains a three-dimensional pressure distribution showing the changes in the pressure values according to location and time by using the time, pressure values, and locations in which the pressure sensors are disposed within the arbitrary location section, and a volume integral calculation portion that calculates the volume integral value of the interest location which is predetermined in accordance with the disease, in the three-dimensional pressure distribution
Wherein the arbitrary location section includes a first section corresponding to a rectum area and a second section corresponding to an anus area when the manometry is inserted, and the volume integral calculation portion sets the first section to the interest location section to calculate the volume integral value, when the disease is constipation and sets the second section to the interest location to calculate the volume integral value, when the disease is fecal incontinence.
Also, the apparatus for detecting anus diseases using a manometry in a case that the disease is constipation, may further include a ratio calculation portion that calculates a ratio of a volume integral value of the first section to the entire volume integral value of the three-dimensional pressure distribution, a threshold value comparing portion that compares the calculated ratio with a predetermined threshold value, and a disease determination portion that determines that there is constipation disease, if the calculated ratio is less than the threshold value.
Also, the apparatus for detecting anus diseases using a manometry in a case that the disease is fecal incontinence, may further include a threshold value comparing portion that compares a volume integral value of the second section with a predetermined threshold value, and a disease determination portion that determines that there is fecal incontinence disease, if the volume integral value of the second section is less than the threshold value.
Also, the apparatus for detecting anus diseases using a manometry may further include a section dividing portion that divides the arbitrary location section to a first section and a second section within the arbitrary location section according to the predetermined ratio, if the ratio of the first section and the second section is predetermined, and an interest section setting portion that sets an interest section among the first section and the second section.
And, the present invention provides a method for detecting esophagus disease using high resolution esophagus impedance manometry that a plurality of impedance electrodes are disposed at predetermined intervals along an arbitrary location section of a length direction that include obtaining each impedance value from the plurality of impedance electrodes for a predetermined time, obtaining conductance value by reversing the obtained impedance value, obtaining three-dimensional conductance distribution showing conductance change according to location and time by using the time, the conductance value, and locations that each impedance electrode is disposed within the arbitrary location section, and calculating entire volume integral value for the three-dimensional conductance distribution.
Wherein, the method for detecting esophagus disease using high resolution esophagus impedance manometry may further include comparing entire volume integral value for the three-dimensional conductance distribution with a predetermined threshold value, and determining that there is esophagus disease, if the calculated ratio is larger than the threshold value.
Also, the calculating entire volume integral value calculates volume integral value of a predetermined interest location section within the three-dimensional conductance distribution in a case that a patient has a disorder in a esophagus, and the interest location section is a section corresponding to a normal esophagus area not having disorder among the arbitrary location sections when the high resolution esophagus impedance manometry is inserted.
Also, the method for detecting esophagus disease using high resolution esophagus impedance manometry may further include setting the interest location section within the arbitrary location section.
And, this invention provide an apparatus for detecting esophagus disease using high resolution esophagus impedance manometry that a plurality of impedance electrodes are disposed at predetermined intervals along an arbitrary location section of a length direction that includes an impedance obtaining portion that obtains each impedance value from the plurality of impedance electrodes for a predetermined time, a conductance obtaining portion that obtains conductance value by reversing the obtained impedance value, a three-dimensional distribution obtaining portion that obtains three-dimensional conductance distribution showing conductance change according to location and time by using the time, the conductance value, and locations that each impedance electrode is disposed within the arbitrary location section, and a volume integral calculation portion that calculates entire volume integral value for the three-dimensional conductance distribution.
Wherein the apparatus for detecting esophagus disease using high resolution esophagus impedance manometry may further include a threshold value comparing portion that compares entire volume integral value for the three-dimensional conductance distribution with a predetermined threshold value, and a disease determination portion that determining that there is esophagus disease, if the calculated ratio is larger than the threshold value.
Also, the volume integral calculation portion calculates volume integral value of a predetermined interest location section within the three-dimensional conductance distribution in a case that a patient has a disorder in a esophagus, and the interest location section is a section corresponding to a normal esophagus area not having disorder among the arbitrary location sections when the high resolution esophagus impedance manometry is inserted.
Also, the apparatus for detecting esophagus disease using high resolution esophagus impedance manometry may further include an interest section setting portion that sets the interest location section within the arbitrary location section.
According to a method for detecting disease using a high resolution manometry, and an apparatus thereof of the present invention, pressure values of partial sensor related to rectum or anus area are used among a plurality of sensors provided in the manometry during the insertion of a manometry to be able to enhance determination efficiency of each disease related to rectum anus.
Also, according to the present invention, an inverse number of impedance of a plurality of impedance electrodes provided in a high resolution esophagus impedance manometry is used to obtain space-time three-dimensional distribution of conductance, and these are used to be able to improve esophagus disease determination efficiency.
The present invention will be described more fully hereinafter with reference to the accompanying drawings, in which exemplary embodiments of the invention are shown.
The present invention relates to a method for detecting disease using a high resolution manometry, and an apparatus thereof. The present invention is divided to main two exemplary embodiments. Firstly, a first exemplary embodiment of the present invention provides an anus rectum disease detection method using high resolution anus rectum manometry and the apparatus thereof. And, a second exemplary embodiment of the present invention provides a esophagus disease detection method high resolution esophagus manometry and the apparatus thereof.
Hereinafter, firstly a first exemplary embodiment of the present invention will be described in detail.
A first exemplary embodiment of the present invention relates to an anus rectum disease detection method using a high resolution anus rectum manometry, a manometry that a plurality of pressure sensors is disposed at a predetermined interval along a length direction is used to detect an internal pressure of anus or rectum area, the detected value is used to detect the disease such as constipation or fecal incontinence.
Generally, a manometry is a device that is used for detecting internal pressure of rectum and anus, and various types thereof are well known to.
Referring to
As shown in
In addition to the pressure sensors for detecting the internal pressure, a manometry 10 may include configurations such as Intra-balloon Pressure Sensor, Anal Verge Position Band, Rectal Pressure Sensor, and External Reference Channel as shown in
In a first exemplary embodiment of the present invention, the sensor corresponding to the rectum area among entire sensors may be used to verify constipation disease, and the sensor corresponding to the anus area may be used to verify fecal incontinence disease. As shown in
Hereinafter, a method for detecting anus disease using a manometry and the apparatus thereof according to first exemplary embodiment of the present invention will be described in detail. Just, for better comprehension and ease of description, one exemplary embodiment that one pressure sensor is disposed at each divided section is described.
Referring to
Firstly, a pressure value obtaining portion 110 obtains each pressure value from a plurality of pressure sensor of a manometry 10 for a predetermined time S310. As shown in
The S310 obtains pressure values from the pressure sensors those are disposed on the divided five sections, and this is continued for a predetermined time. Then, sensing value change of each pressure sensor may be obtained as time passes, and sensing value change may be obtained depending on the location of each pressure sensor, (mounting location in the manometry)
After this, a three-dimensional distribution obtaining portion 120 uses location that each pressure sensor is disposed within the arbitrary location section, time, and the obtained pressure value to obtain three-dimensional pressure distribution that shows the changes of the pressure values according to the location and the time S320.
Meanwhile, each pressure sensor is disposed at an interval of 1 centimeter along the length direction of the manometry 10 (Y axis direction) in a first exemplary embodiment of the present invention, and therefore pressure value between the sections (that the sensor is not mounted) cannot be obtained. However, if a curved line smooth method is used by connecting each point location, continuous data may be obtained between the sections as shown in
In a first exemplary embodiment of the present invention, data of
In a first exemplary embodiment of the present invention, the arbitrary location section includes a first section corresponding to rectum area (an upper section among five sections in
On the premises, the volume integral calculation portion 130 sets the first section (an upper section) to the interest location section to calculate volume integral value in a case that the disease is constipation, and sets the second section (lower sections) to the interest location section to calculate volume integral value in a case that the disease is fecal incontinence.
For example, if a constipation disease test is selected by an user, a first section (an upper section) is set to an interest location section, and if fecal incontinence disease test is selected by an user, second sections (lower sections) are set to an interest location section to calculate volume integral value. An apparatus according to a first exemplary embodiment of the present invention further include an input portion for setting of a user.
Based on the above description, hereinafter, a detailed examination method will be described for constipation disease using a first section.
First, a ratio calculation portion 140 calculates a ratio of a volume integral value of the first section (upper section) to an entire volume integral value of the three-dimensional pressure distribution in a case that the examination disease is constipation S510. For example, an entire volume integral value (A) is calculated for three-dimensional pressure distribution of
Then, a threshold value comparing portion 150 compares the calculated ratio to a predetermined first threshold value S520. Here, in the S510, if the calculated ratio is larger than the first threshold value, it is determined to a normal condition, and if it is less than the first threshold value, it is determined that there is constipation disease S530.
Next, an examination method using a second section for fecal incontinence will be described in detail.
Like this, in a case that an examination disease is fecal incontinence, a volume integral calculation portion 130 calculates volume integral value of a second section (lower section) in S330.
After this, as shown in
Here, the first section (upper section) and the second section (lower section) may be varied depending on the body structure of the patient. Two sections may be finally set depending on the body condition of the patient. The disease determination accuracy and reliability may be further enhanced through this process.
For this purpose, a first exemplary embodiment of the present invention includes a section dividing portion 170 and an interest section setting portion 180. If the section dividing portion 170 receives the set ratio between the first section and the second section within the arbitrary location section to divide the arbitrary location section to a first section (upper section) and a second section (lower section) depending on the set ratio.
For example, the ratio of 1:4 is set by an user, a first section and a second section are automatically divided as shown in
After this, an interest section setting portion 180 sets the interest location section from the first section (upper section) and the second section (lower section). That is, if constipation disease is suspected, a first section is set to an interest location section, and a method of
As described above, in a method for detecting disease using a manometry and the apparatus thereof according to a first exemplary embodiment of the present invention, pressure values of the related sensors that are related to rectum or anus area among a plurality of sensors that are disposed in the manometry are used to verify various disease related to rectum anus, and the determination efficiency is enhanced while the manometry is inserted.
Also, three-dimensional volume distribution that pressure values of each sensor is processed in time and space is used according to a first exemplary embodiment of the present invention, different from that a simple pressure value is used in a conventional anorectal manometry, such that this process may suggest new method that may verify functional colon anus movement disease.
Hereinafter, a second exemplary embodiment of the present invention will be described in detail.
A second exemplary embodiment of the present invention relates to a esophagus disease detection method and the apparatus thereof using a high resolution esophagus impedance manometry, and a detection value of a high resolution esophagus impedance manometry that a plurality of impedance electrodes are disposed along the length direction at a predetermined interval is used to verify the disease within esophagus.
Referring to
A second exemplary embodiment of the present invention may provide a method that may show objective value from the values detected from the impedance sensors those are arranged at 2 centimeters interval on the high resolution impedance manometry, and this method is based on the theory that the esophagus movement has a problem, if the swallowed bolus cannot get out of the esophagus within a predetermined time to remain in the esophagus.
A high resolution esophagus impedance manometry shown in
Hereinafter, a second exemplary embodiment of the present invention will described a esophagus disease detection method and the apparatus using a high resolution esophagus impedance manometry.
Referring to
Firstly, an impedance obtaining portion 210 obtains each impedance value from a plurality of impedance electrodes provided in the impedance manometry 20 for a predetermined time S1110.
As shown in
The S1110 step obtains impedance value from each impedance electrode, and this is continued for a predetermined time. Then, change property of the impedance value in each impedance electrode may be obtained according to time, and change property of the impedance value may be obtained according to the location of the impedance electrode (mounting location in the impedance manometry 20).
After this, a conductance obtaining portion 220 reverse the obtained impedance value to calculate the conductance value S1120. The S1120 step denotes that all impedance values obtained in the previous S1110 step is reversed to be changed to the conductance value.
Next, a three-dimensional distribution obtaining portion 230 uses location that each impedance electrode is disposed within arbitrary location section that the electrode is disposed, the time, and the conductance value and obtains three-dimensional conductance distribution that denotes conductance change according to the location and time S1130.
Meanwhile, in a second exemplary embodiment of the present invention, because each impedance electrode is disposed along the length direction (Y axis direction) of the impedance manometry 20 at an interval of 2 centimeters, the conductance value between them cannot be obtained in detail. However, if a curved line method is used to connect each point location, continuous data may be obtained between each point as shown in
Of course, this method may be equally applied to conductance values (X axis direction) according to time. Like this, a method that the calculated each points are connected to form a curved line and a curved surface can use a method that is well known to a person skilled in this art.
In a second exemplary embodiment of the present invention, data of
In that order, a threshold value comparing portion 250 compares the entire volume integral value for the three-dimensional conductance distribution with a predetermined threshold value S1150. Next, a disease determination portion 260 determines that a patient has the esophagus disease, if the calculate ratio is larger than the threshold value S1160.
A conductance is a concept that is in opposition to impedance, if the impedance is low, the possibility of the disease is increased, and therefore if the conductance value is high, the possibility of the disease is high.
Here, in a case that a patient has a possibility to have a esophagus disorder, the entire of the three-dimensional conductance distribution is not used and a partial section (ex, 10 to 20 centimeters) is used. That is, in the S1140 step, volume integral value of a predetermined interest location section is calculated within the three-dimensional conductance distribution in a case that a patient has a esophagus disorder. That is, the volume integral value of the partial section is compared to a threshold value so as to verify the disease possibility. The threshold value that is used in this process may be less than a threshold value that is used for the entire section. That is, the threshold value may be varied in proportion to ratio of a partial length section to the entire electrode length section.
Here, the interest location section may denotes a section that corresponds to normal esophagus area not having esophagus disorder among sections that electrodes, when the impedance manometry 20 are disposed is inserted into esophagus. That is, in a case that a patient has a partial disorder in esophagus function, the section not having function disorder is used to determine whether the esophagus is normal or abnormal, and has lesion or not.
Here, in a second exemplary embodiment of the present invention, because the area having normal function is different depending on examinee (or patient), a function that may set an interest section is included. That is, an interest section setting portion 280 may set the interest location section within the section (0 to 30 centimeters) that the impedance electrodes are disposed in the impedance manometry 20. A process that sets the interest location section may be performed before S110 step of
As described above, a second exemplary embodiment of the present invention uses an inverse number of impedance of a plurality of impedance electrodes provided in a high resolution esophagus impedance manometry to obtain space-time three-dimensional distribution of conductance, and these are used to be able to improve esophagus disease determination efficiency.
Also, according to a second exemplary embodiment of the present invention, differently from that an impedance value is simply compared to a standard value in a conventional impedance test, three-dimensional conductance distribution that a conductance value that an impedance value of each electrode is reversed is processed in time and space is used, and a new esophagus disease detection method that three-dimensional integral volume according to time and space is used may be introduced.
While this invention has been described in connection with what is presently considered to be practical exemplary embodiments, it is to be understood that the invention is not limited to the disclosed embodiments, but, on the contrary, is intended to cover various modifications and equivalent arrangements included within the spirit and scope of the appended claims.
Claims
1. A method for detecting esophagus disease using high resolution esophagus impedance manometry that a plurality of impedance electrodes are disposed at predetermined intervals along an arbitrary location section of a length direction, comprising;
- obtaining each impedance value from the plurality of impedance electrodes for a predetermined time;
- obtaining conductance value by reversing the obtained impedance value;
- obtaining three-dimensional conductance distribution showing conductance change according to location and time by using the time, the conductance value, and locations that each impedance electrode is disposed within the arbitrary location section; and
- calculating entire volume integral value for the three-dimensional conductance distribution.
2. The method for detecting esophagus disease using high resolution esophagus impedance manometry of claim 1, further comprising;
- comparing entire volume integral value for the three-dimensional conductance distribution with a predetermined threshold value; and
- determining that there is esophagus disease, if the calculated ratio is larger than the threshold value.
3. The method for detecting esophagus disease using high resolution esophagus impedance manometry of claim 1, wherein:
- the calculating entire volume integral value calculates volume integral value of a predetermined interest location section within the three-dimensional conductance distribution in a case that a patient has a disorder in a esophagus, and
- the interest location section is a section corresponding to a normal esophagus area not having disorder among the arbitrary location sections when the high resolution esophagus impedance manometry is inserted.
4. The method for detecting esophagus disease using high resolution esophagus impedance manometry of claim 3, wherein further comprising;
- setting the interest location section within the arbitrary location section.
5. An apparatus for detecting esophagus disease using high resolution esophagus impedance manometry that a plurality of impedance electrodes are disposed at predetermined intervals along an arbitrary location section of a length direction, comprising:
- an impedance obtaining portion that obtains each impedance value from the plurality of impedance electrodes for a predetermined time;
- a conductance obtaining portion that obtains conductance value by reversing the obtained impedance value;
- a three-dimensional distribution obtaining portion that obtains three-dimensional conductance distribution showing conductance change according to location and time by using the time, the conductance value, and locations that each impedance electrode is disposed within the arbitrary location section; and
- a volume integral calculation portion that calculates entire volume integral value for the three-dimensional conductance distribution.
6. The apparatus for detecting esophagus disease using high resolution esophagus impedance manometry of claim 5, wherein:
- a threshold value comparing portion that compares entire volume integral value for the three-dimensional conductance distribution with a predetermined threshold value; and
- a disease determination portion that determining that there is esophagus disease, if the calculated ratio is larger than the threshold value.
7. The apparatus for detecting esophagus disease using high resolution esophagus impedance manometry of claim 5, wherein:
- the volume integral calculation portion calculates volume integral value of a predetermined interest location section within the three-dimensional conductance distribution in a case that a patient has a disorder in a esophagus, and
- the interest location section is a section corresponding to a normal esophagus area not having disorder among the arbitrary location sections when the high resolution esophagus impedance manometry is inserted.
8. The apparatus for detecting esophagus disease using high resolution esophagus impedance manometry of claim 7, wherein further comprising;
- an interest section setting portion that sets the interest location section within the arbitrary location section.
Type: Application
Filed: Jul 17, 2020
Publication Date: Nov 5, 2020
Applicant: UNIVERSITY OF ULSAN FOUNDATION FOR INDUSTRY COOPERATION (Ulsan)
Inventors: Se Gyeong JOO (Seoul), Kee Wook JUNG (Seoul), Seung Jae MYUNG (Seoul), Hwoon Yong JUNG (Seoul)
Application Number: 16/931,456