This invention relates to medical devices and methods, and more particularly to such devices and methods for analyzing body sounds.
Body sounds are routinely used by physicians in the diagnosis of various disorders. A physician may place a stethoscope on a person's chest or back and monitor the patient's breathing in order to detect adventitious (i.e. abnormal or unexpected) lung sounds. The identification and classification of adventitious lung sounds often provides important information about pulmonary abnormalities.
It is also known to fix one or more microphones onto a subject's chest or back and to record lung sounds. U.S. Pat. No. 6,139,505 discloses a system in which a plurality of microphones are placed around a patient's chest. The recordings of the microphones during inhalation and expiration are displayed on a screen, or printed on paper. The recordings are then visually examined by a physician in order to detect a pulmonary disorder in the patent. Kompis et al. (Chest, 120(4), 2001) disclose a system in which M microphones are placed on a patient's chest, and lung sounds are recorded. The recordings generate M linear equations that are solved using a least-squares fit. The solution of the system is used to determine the location in the lungs of the source of a sound detected in the recordings.
In the following description and set of claims, two explicitly described, calculable, or measurable variables are considered equivalent to each other when the two variables are proportional to one another.
The present invention provides, in one of its embodiments, a system and method for recording and analyzing respiratory tract sounds produced in the respiratory tract. The system includes a plurality of N transducers (microphones) configured to be attached to an essentially planar region R of the individual's back or chest over the individual's thorax. Positions in the region R are indicated by two-dimensional position vectors x=(x1,x2) in a two-dimensional coordinate system defined in the planar region R. The ith transducer, for i=1 to N, is fixed at a position xi in the region R and generates a signal, denoted herein by P(xi,t), indicative of pressure waves in the body arriving at xi.
The transducers are typically embedded in a matrix that permits to affix them easily onto the individual's skin. Such a matrix may typically be in the form of a vest or garment for easily placing over the individual's thorax. As may be appreciated, different matrices may be used for differently sized individuals, for different ages, sexes, etc.
The N signals P(xi, t) are processed by signal processing circuitry. In accordance with the invention, the processing involves determining from the N signals an average acoustic energy, denoted herein by {tilde over (P)}(x,t1,t2), at least one position x in the region R over a time interval from t1 to t2. The term “acoustic energy” at a location is used herein to refer to a parameter indicative of or approximating the product of the pressure and the mass propagation velocity at that location.
In one embodiment, an average acoustic energy over a time interval from t1 to t2 is obtained at a position of one of the microphones using the algebraic expression:
In a more preferred embodiment, an average acoustic energy {tilde over (P)}(xi, ti, t2) over a time interval from t1 to t2 is obtained at a plurality of positions xi of the microphones, for example using Equation (1), and then calculating {tilde over (P)}(x, t1,t2) at other locations x by interpolation of the {tilde over (P)}(xi,t1,t2) using any known interpolation method.
In a most preferred embodiment, the interpolation is performed to obtain an average acoustic energy {tilde over (P)}(x,t1,t2) at a position x=(x1,x2) in the surface R using the algebraic expression:
where g(x,xi,σ) is a kernel satisfying
and where xi=(xi1,xi2) is the position of the ith microphone and σ is a selectable parameter.
For example, the kernel
may be used.
The system may optionally contain a display device for displaying the function {tilde over (P)}. The function {tilde over (P)} may be displayed on the display, for example using a gray level scale, as demonstrated in the examples below. A two dimensional graphical representation of the function {tilde over (P)} produces an image of the body region that may be analyzed for the detection of a disorder in the body region similar to the analysis of images obtained by other imaging methods such as X-ray or ultrasound imaging.
A region or regions in a displayed image that are suspected of including a pathological condition, may de identified in the image, and this may be in a number of ways, for example, by different colors, by different patterns, by way of a written text, and many other ways. The term “pathological condition” refers to any deviation from the normal, healthy condition of the respiratory tract. This includes infection, inflammation, tumor, pleural effusion, pneumonia, narrowing of the airways, and other space containing lesions in the respiratory tract, etc.
Additionally, a time interval can be divided into a plurality of sub intervals, and an average acoustic energy {tilde over (P)} determined over the region R for two or more of the sub intervals. An image of {tilde over (P)} for each of these sub intervals may then be determined and displayed sequentially on the display device. This generates a movie showing dynamic changes occurring in the acoustic energy in the body region, over the time interval. For example, transducers may be placed on a person's chest and an average acoustic energy {tilde over (P)} determined in accordance with the invention for a plurality of sub intervals over a breathing cycle. An image can be obtained for each of these sub intervals and displayed sequentially so as to generate a movie showing changes in the acoustic energy of the lungs over the breathing cycle.
The signals P(xi,t) may also be subjected to band pass filtering before being analyzed by the method of the invention, so that an average acoustic energy is produced for one or more frequency bands of interest. The functions may be superimposed on the display device by representing each average acoustic energy function with a different color. Since respiratory sounds known as “wheezes” and “crackles” have different characteristic frequency ranges, band pass filtering can be used to identify these respiratory sounds. A region or regions in a displayed image of wheezes or crackles may be identified in the image, for example, by a characteristic color, pattern, by way of a written text.
The present invention thus provides a system for analyzing sounds in at least portion of an individual's respiratory tract comprising:
The present invention further provides a method for analyzing sounds in at least a portion of an individual's thorax, comprising:
The present invention also provides a program storage device readable by machine, tangibly embodying a program of instructions executable by the machine to perform method steps for determining for at least one time interval, an average acoustic energy function {tilde over (P)} using an algorithm involving at least one signal P(xi, t) indicative of pressure waves at a location xi on a body surface.
The present invention still further provides a computer program product comprising a computer useable medium having computer readable program code embodied therein analyzing sounds in at least a portion of an individual's body, the computer program product comprising:
In order to understand the invention and to see how it may be carried out in practice, a preferred embodiment will now be described, by way of non-limiting example only, with reference to the accompanying drawings, in which:
a shows an image obtained on a healthy individual in accordance with the invention, and
a shows an image obtained on an individual with pleural effusion in accordance with the invention, and
a shows an image obtained on an individual with pneumonia in accordance with the invention, and
An input device such as a computer keyboard 140 or mouse 145 is used to input relevant information relating to the examination such as personal details of the individual 110. The input device 140 may also be used to input values of the times t1 and t2. Alternatively, the times t1 and t2 may be determined automatically in a respiratory phase analysis of the signals P(xi,t) performed by the processor 135. The processor 135 determines an average acoustic energy {tilde over (P)}(x,t1,t2) over the time interval from t1 to t2 at least one locations x in the region R in a calculation involving at least one of the signals P(xi,t).
The average acoustic energies are stored in the memory 130 and may be displayed on a display device 150 such as a CRT screen for diagnosis by a physician.
The processor 135 may also perform an automatic differential diagnosis by comparing the function {tilde over (P)} to functions stored in the memory and known to be indicative of various disorders in the body region.
It will also be understood that the system according to the invention may be a suitably programmed computer. Likewise, the invention contemplates a computer program being readable by a computer for executing the method of the invention. The invention further contemplates a machine-readable memory tangibly embodying a program of instructions executable by the machine for executing the method of the invention.
The system and method of the invention were used to analyze lower respiratory tract sounds in an individual.
Movies showing changes in the lungs during a respiratory cycle were obtained using the method and system of the invention. Signals 125 were obtained and divided into time segments of 0.5 sec duration. Each segment was analyzed by the method of the invention and an image was generated. The images were displayed on the display device 150 in rapid succession so as to produce a movie of the respiratory tract over the respiratory cycle.
a shows an image of the respiratory tract of a healthy individual obtained over an entire respiratory cycle in accordance with the invention, and
a shows an image of the respiratory tract of an individual with pleural effusion obtained over an entire respiratory cycle in accordance with the invention, and
a shows an image of the respiratory tract of an individual with pneumonia obtained over an entire respiratory cycle in accordance with the invention, and
This application is a continuation-in-part of Application No. 10/041,494 filed on Jan. 10, 2002 now abandoned, the entire contents of which are hereby incorporated by reference.
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Number | Date | Country | |
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Number | Date | Country | |
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Parent | 10041494 | Jan 2002 | US |
Child | 10338742 | US |