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研究生:徐茂修
論文名稱:用生物阻抗斷層術評估膀胱之功能
論文名稱(外文):Estimation of Bladder Function by Electrical Impedance Tomography
指導教授:傅式恩傅式恩引用關係程千里程千里引用關係
學位類別:碩士
校院名稱:中原大學
系所名稱:醫學工程學系
學門:工程學門
學類:綜合工程學類
論文種類:學術論文
論文出版年:1997
畢業學年度:85
語文別:中文
論文頁數:84
中文關鍵詞:生物阻抗斷層術(EIT)餘尿阻抗體積描針法膀胱排空適應性法多工切換原理
外文關鍵詞:Electrical Impedance TomographyResidual UrineImpedance Plethysmography(IPG)Bladder EmptyAdaptive MethodMultiplexer Switch Theorem
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阻抗量測法(Impedance Measurement Technique)在二十世紀中後期達到一技術上可被認可的階段,且這些方法目前也已被應用在一些生理特性的量測上,在種種生物阻抗量測上所獲得的一些生理知識,提供了我們對許多未知的生物醫學領域有了一番更深的了解。
本研究主要在探討利用生物阻抗斷層術─EIT。來作為一種非侵入性且非游離輻射的技術進而重建膀胱影像斷層面之輪廓,並了解膀胱斷層面積排空比例相對於容積之生理評估。「生物阻抗斷層術」可觀察膀胱尿液阻抗變化的連續圖像,其原理是利用「阻抗體積描計法」,由排尿前後阻抗的差異來了解相對應的膀胱排空變化的動態影像與時間。我們將著重於本研究的斷層掃描方法是採用最佳化適應性法,利用十二個點狀電極環形貼於膀胱部位,再利用多工切換原理得到斷層掃描組織環中均勻激發的電場分布密度,而接收器的設計則採用Bhat在1990年的建議可以利用點電極橫置及縱置正交於腹部恥骨聯合(Symphysis pubis)與肚臍(umbilicus)間,利用此正交排列方式在腹部靠近膀胱的地方,來測量膀胱容積政變時,膀胱附近皮膚表面擷取的阻抗變化。進而利用演算法重建的資訊,則得一膀胱剖面圖像,而圖像面積相對時間軸的比例變化利用阻抗體積描計法即可評估膀胱內尿液的容量。
為了驗證此技術的可行性,我們設計了一個假體及動物實驗來模擬人體的腹部並進行一連串的測試,首先利用豬膀胱置於壓克力燒杯內加以校準面積的變化,爾後將此結果運用於動物實驗;△Z=-0.34667△ A±0.00081,且相關係數達到0.986609以上之線性分佈,並將此結果利用體積與面積的轉移函數,從二維面積空間轉為三維的體積空間,藉此評估膀胱的容積及餘尿。膀胱容積相關係數為0.9971以上偏差量為±13毫升。若能做更多的動物實驗,藉以發展出一非侵入性之較準方法,則本系統將來直接量測人體是可行的。
EIT的量測理論,目前在歐美皆有不少學者從事此阻抗研究,但效果仍待改善。如果想在國內展開膀胱阻抗測量尿液體積的研究,必將自行研發才能達到此目的,相信本研究之結果將有助於泌尿科醫師將生物阻抗斷層術用於臨床診斷。如此生物阻抗量測技術應用於臨床泌尿功能檢測將有更大的空間。
The Impedance Measurement Technique, in the last several decades of 20th century, has earned the recognizable reputation in terms of its technological accomplishment. In the meantime, this methodology has been applied to certain physiological measurements. Those physiological knowledge gained from various biological impedance measurements, provide us better understanding toward many unknown biological medical areas.
The purpose of this study is mainly the investigation of applying the Electrical Impedance Tomography(EIT) as a noninvasive and non-ionized-radiative method, in order to reconstruct the outline of the bladder tomography and realize the physiological estimation of the bladder cross-section area empty ratio with respect to the bladder volume. The EIT could be used to observe continuous graphs of the change of bladder urine impedance. Its basic principle is applying the Impedance Plethysmography to compare the difference of urine impedance before and after urination and then use the results to investigate the dynamical graphs and time for its corresponding change of bladder empty. The EIT method, we will focus in this study, is utilizing the optimal adaptive method. By switching method, we place twelve electrodes in a circular array around the lower abdomen to gain the distribution density of electrical field which is generated evenly by the organ rings of the scanned cross-section. Meanwhile, the design of receiver is based on the proposal of Bhat in 1990. In that proposal, he suggest placing matrix-arranged point electrodes between symphysis pubis and umbilicus, then use this orthogonal arranged style sensors to measure the impedance change picked up from the skin around the bladder, Since such change is due to the bladder volume change, further information can be rebuilt by computational methods and the bladder cross-section graph could then be obtained. The volume of urine in bladder could be estimated by using Plethysmography to calculate the ratio change of the area of the cross-section graph with respect to the time axis.
In order to prove the feasibility of this technique, we have designed a dummy and animal experiment to simulate human's abdomen. First of all, we utilize pig's bladder in the oval perspex tank to calibrate the area alteration, then we apply to the result △Z=-0.34667△ A±0.00081 to dog experiment. Besides, The linear correlation is more than 0.986609. We can also use the relation of the area to volume transform function to calculate dog's bladder capacity with R=0.9971, guantizing error ±13ml. If we make experiments on more animals, a noninvasive calibration way will be developed. So We can confirm, the rehability of applying such a system to measure human's body directly.
The research of EIT are currently interesting by many investigators in Europe and USA. However, the performance and results still need to be improved. If similar research were conduct in Taiwan, they have to be done independently. We believe the result of our study will help the urinologist to use impedance tomography in clinic. In that way, there will be more room for applying the biological impedance measurement technique in clinical urine function diagnostics.
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