NONINVASIVE MEASUREMENT OF INTRACRANIAL PRESSURE

无创测量颅内压

基本信息

批准号：
6188686
负责人：
NOAM ALPERIN
金额：
$ 11.59万
依托单位：
UNIVERSITY OF ILLINOIS AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
1999
资助国家：
美国
起止时间：
1999-08-01 至 2002-07-31
项目状态：
已结题

项目摘要

Elevated intracranial pressure (ICP) remains a critical problem in management of patients with neurological problems and is the most common cause of death in these patients. Elevated ICP can be managed and treated if detected at an early stage. Therefore, measurement of ICP is important for diagnosis and treatment decisions. At present, only invasive techniques are available for measurement of absolute ICP. These techniques require physical penetration of the central nervous system (CNS). The objective of this project is to develop the technology for non-invasive measurement of ICP. The non-invasive measurement of ICP would be at a lower cost and without risk or pain to the patient. Hence, this important clinical parameter would be measured more often and may significantly improve the diagnosis and treatment decisions for patients with neurological problems. The proposed project integrates knowledge from human neuro-physiology, principles of fluid dynamics, and dynamic MRI techniques in developing a novel method to non-invasively measure ICP. The technique is novel as it makes use of the change in intracranial volume (ICV) and ICP that occur naturally during each cardiac cycle rather than altering the state of the CNS by external intervention. Since the ratio of intracranial pressure and volume changes is a known function of ICP, a measurement of the ratio of these changes provides a measure of ICP. The changes in ICP and ICV during the cardiac cycle will be computed from MRI measurements of cerebrospinal fluid (CSF) and blood volumetric flow rates. The ICV change will be obtained from the net volumetric flow of blood and CSF into the cranium. The ICP changes will be estimated from pulsatile CSF pressure gradient. The CSF pressure gradient will be computed from dynamic MRI CSF flow measurement in the cervical spine. In preliminary work on a baboon, the change in ICP (i.e., the peak-to-peak pulsatile ICP) was linearly correlated with the peak-to-peak of the pulsatile CSF pressure gradient. The objective of this project is to demonstrate the feasibility of the proposed technology. The specific aims are: 1. Optimize the MRI protocol and data analysis for reproducibility and accuracy of ICV change and pressure gradient measurements. 2. Evaluate the accuracy of the estimated ICP changes from CSF pressure gradient measurements using animal model and computational fluid dynamic simulations. 3. Evaluate accuracy of the non-invasive technique by comparison with invasive measurements on an animal model of normal and elevated ICP.

颅内压升高（ICP）仍然是神经系统问题患者的治疗中的关键问题，并且是这些患者最常见的死亡原因。如果在早期检测到升高的ICP可以管理和处理。因此，ICP的测量对于诊断和治疗决策很重要。目前，仅可用于测量绝对ICP。这些技术需要中枢神经系统（CNS）的身体渗透。该项目的目的是开发用于非侵入性测量ICP的技术。 ICP的非侵入性测量将以较低的成本，并且对患者没有风险或痛苦。因此，该重要的临床参数将更频繁地衡量，并可能显着改善神经系统问题患者的诊断和治疗决策。拟议的项目将知识从人类神经生理学，流体动力学原理和动态MRI技术纳入开发一种新型方法以非侵入性测量ICP。该技术是新颖的，因为它利用了在每个心脏周期中自然发生的颅内体积（ICV）和ICP的变化，而不是通过外部干预来改变CNS的状态。由于颅内压和体积变化的比率是ICP的已知函数，因此测量这些变化的比率提供了ICP的量度。心脏周期期间ICP和ICV的变化将根据脑脊液（CSF）和血液体积流量的MRI测量进行计算。 ICV变化将从血液和脑脊液的净体积流入颅骨中获得。 ICP变化将从脉冲CSF压力梯度估计。 CSF压力梯度将根据颈椎的动态MRI CSF流量测量计算。在狒狒的初步工作中，ICP的变化（即峰峰脉冲ICP）与脉冲CSF压力梯度的峰值峰线线性相关。该项目的目的是证明拟议技术的可行性。具体目的是：1。优化MRI协议和数据分析，以获得ICV变化和压力梯度测量的可重复性和准确性。 2。使用动物模型和计算流体动力学模拟，评估CSF压力梯度测量结果估计的ICP变化的准确性。 3。通过比较非侵入性技术的准确性，与ICP的动物模型上的侵入性测量值进行比较。