INTESTINAL WALL INVESTIGATION BY ENDOSCOPIC ECHO PROBE

胃肠道内窥镜检查，虽然非常有用， 因为只能看到肠壁的粘膜内层。 内窥镜超声提供了一种方法， 粘膜，但现有的设备是昂贵和困难的 使用. 我们开发了一种更简单的方法 使用穿过活检通道的探头的超声， 传统内窥镜。 用这个新的内窥镜回声探头 (EEP)我们获得了正常动物的超声图像， 切除正常和异常的人胃肠道壁， 确定了需要进一步研究的领域。 我们会继续追查 EEP开发采用3种类型的超声探头， 调查关于胃肠道壁的具体问题。 EEP-1： 我们将改进我们目前的EEP（20 MHz探头）， 探讨其在胃肠道粘膜病变成像中的应用。 非甾体类抗炎药诱导（NSAID） 将研究胃十二指肠损伤和消化性溃疡复发， 确定病变深度和特征。 NSAID诱导的胃 将跟踪正常受试者和患者的糜烂， 确定超声特征是否可以区分 其侵蚀最终加深形成溃疡。 十二指肠溃疡 将在愈合阶段用EEP-I成像，以确定 溃疡下面的组织是否有特征 预测复发 EEP-2：低频探头（10-18 MHz） 并将开发一个多频系统来研究 食管和结肠肿瘤的分期需要 比20 MHz EEP.1更深的穿透超声能量。 食管和结肠病变中的肿瘤浸润将是 调查以确定是否更准确的非手术分期 与EEP-2的关系可能有助于治疗的结果。 M模式：我们 将开发出附着在肠壁上的探针，并产生M- 模式信号，显示收缩期间肌肉增厚 并且在松弛期间变薄。 这种新方法将 用于研究动物和人类的肌肉生理学， 对胃肠道问题的病理生理学洞察 与肠道运动异常有关 最后，这些设备中的每一个都将在 然后在动物中测试安全性和有效性。 将进行初步临床试验以确定具体的 问题如果存在。 正式的临床试验将遵循， 建立这些设备的价值，并提供新的 了解重要的病理生理过程 上面讨论过。

Gastrointestinal endoscopy, although highly useful, is limited because only the mucosal lining of the intestinal wall is seen. Endoscopic ultrasound provides a method to view tissue beneath the mucosa, but the existing equipment is expensive and difficult to use. We have developed a simpler method of applying ultrasound that uses a probe passed through the biopsy channel of conventional endoscopes. With this new endoscopic echo probe (EEP) we have obtained ultrasound images of normal animal and excised normal and abnormal human gastrointestinal wall and identified areas needing further study. We will pursue further EEP development with 3 types of ultrasound probes designed to investigate specific questions about the gastrointestinal wall. EEP-1: We will refine our current EEP (20 MHz probe) and investigate its use in imaging mucosal gastrointestinal lesions. Nonsteroidal anti-inflammatory drug-induced (NSAID) gastroduodenal injury and peptic ulcer relapse will be studied to determine lesion depth and character. NSAID induced gastric erosions in normal subjects and patients will be followed to determine whether ultrasound characteristics can distinguish which erosions eventually deepen to form ulcers. Duodenal ulcers will be imaged with EEP-l in the healing phase to determine whether there are characteristics of the tissue under the ulcer predicting relapse. EEP-2: Lower frequency probes (10-18 MHz) and a multiples frequency system will be developed to study staging of esophageal and colonic neoplasia which require a deeper penetrating ultrasonic energy than the 20 MHz EEP.l. Neoplastic invasion in esophageal and colonic lesions will be investigated to determine if more accurate nonoperative staging with EEP-2 can contribute to the outcome of therapy. M-mode: We will develop probes that attach to the gut wall, and generate M- mode signals, which shows muscle thickening during contraction and thinning during relaxation. This new methodology will be used to study muscle physiology in animals and humans and provide pathophysiologic insight into gastrointestinal problems associated with abnormal intestinal mobility. Finally, each of these devices as developed, will be studied in vitro and then tested for safety and efficacy in animals. Initial clinical trials will be conducted cc identify specific problems if they exist. Formal clinical trials will follow to establish the value of these devices and to provide new understanding of the important pathophysiologic processes discussed above.