INTESTINAL WALL INVESTIGATION BY ENDOSCOPIC ECHO PROBE

胃肠道内窥镜检查虽然非常有用，但也是有限的。 因为只能看到肠壁的粘膜衬里。 内窥镜超声提供了一种观察下方组织的方法 黏膜，但现有的设备昂贵，难度大 来使用。我们已经开发出一种更简单的应用方法 使用通过活检通道的探头的超声波 传统的内窥镜检查。用这种新的内窥镜回声探头 (EEP)我们已经获得了正常动物和 切除正常和异常的人胃肠壁和 确定了需要进一步研究的领域。我们将进一步追查 具有3种超声探头的EEP开发 调查有关胃肠壁的具体问题。 EEP-1：我们将改进我们目前的EEP(20 MHz探头)和 探讨其在胃肠道粘膜病变成像中的应用。 非甾体抗炎药(NSAID) 胃十二指肠损伤和消化性溃疡复发将被研究以 确定病变深度和特征。非甾体抗炎药所致胃病 正常受试者和患者的糜烂将被追踪到 确定超声特征是否可以区分 它们的侵蚀最终加深形成溃疡。十二指肠溃疡 将与EEP-L在康复阶段进行成像以确定 溃疡下组织有无特征性 预测复发。EEP-2：较低频率探头(10-18 MHz) 并将开发一台倍频系统进行研究 食道和结肠肿瘤的分期需要 比20 MHz EEP.l更深的穿透超声能量。 食道和结肠病变的肿瘤侵袭将是 调查以确定是否有更准确的非手术分期 联合应用EEP-2有助于改善治疗效果。M-MODE：我们 将开发附着在肠壁上的探针，并产生M- 模式信号，显示肌肉在收缩过程中增厚 在放松过程中变薄。这一新的方法将是 用于研究动物和人类的肌肉生理学，并提供 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 然后在动物身上进行安全性和有效性测试。 将进行初步临床试验，以确定具体的 如果存在问题的话。正式的临床试验将在随后进行 确立这些设备的价值并提供新的 对重要的病理生理过程的理解 如上所述。

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.