Modeling The Pediatric Upper Airway Using Anatomic Optical Coherence Tomography a

使用解剖光学相干断层扫描对儿科上呼吸道进行建模

• 批准号: 8144821
• 负责人: ZHONGPING CHEN
• 金额: $ 94.79万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-17 至 2014-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8144821
• 关键词: 3-Dimensional; Address; Affect; Air; Anatomic Sites; Anatomy; Biological; Biology; Child; Childhood; Cine Magnetic Resonance Imaging; Clinical; Clinical Sensitivity; Complex; Computer software; Data; Development; Device Designs; Diagnostic; Diagnostic tests; Down Syndrome; Elements; Equation; Evaluation; Functional disorder; Head and neck structure; Health; Health Care Costs; Hypertrophy; Image; Imaging technology; Ionizing radiation; Judgment; Lasers; Lead; Life; Liquid substance; Location; Magnetic Resonance Imaging; Maps; Measurement; Measures; Medical center; Medicine; Methods; Microscopic; Modeling; Morbidity - disease rate; Obesity; Obstruction; Operative Surgical Procedures; Optical Coherence Tomography; Optics; Organ; Outcome; Outcome Measure; Patient Selection; Patients; Pharyngeal structure; Physiological; Play; Recruitment Activity; Reporting; Research; Resolution; Risk; Role; Sedation procedure; Shapes; Simulate; Sleep; Speed; Staging; Structure; Supercomputing; Surgeon; System; Techniques; Technology; Three-Dimensional Image; Three-Dimensional Imaging; Time; Tissues; Trachea; Translational Research; Translations; United States; X-Ray Computed Tomography; airway obstruction; awake; base; cost; craniofacial; data modeling; design; imaging modality; improved; in vivo; in vivo Model; international center; model development; models and simulation; neuromuscular; operation; pediatrician; pressure; programs; research and development; response; second harmonic; simulation; technology development; time interval; tomography; tool

DESCRIPTION (provided by applicant): Modeling The Pediatric Upper Airway Using Anatomic Optical Coherence Tomography and Computational Fluid Dynamics (DNS) Project Summary Upper airway obstruction is a problem that affects up to 3% of all children. The problem is multifactorial and includes both anatomic and neuromuscular elements. The most common cause of upper airway obstruction is related to adenotonsillar hypertrophy. Adenotonsillectomy (AT) is among the most common operations performed the United States with about 600,000 children undergoing AT each year. AT results in significant improvement in relieving symptomatic airway obstruction in the vast majority of children; still large numbers of children do not benefit from this treatment and this is particularly true in children with craniofacial anomalies, Down's syndrome, and obesity. Identifying children who fail to respond to AT prior to surgery is exceptionally challenging. This proposal is in response to the RFA-HL-10-017 and aimed at developing and validating new modeling and in vivo measurement tools for evaluating/predicting upper airway dysfunction in children. The integrated multi-center international team will focus on the development of computation models using direct numerical simulation models for airflow to identify the biological and structural components creating airflow limitation in the pediatric upper airway. To provide in vivo structural data for modeling, we will develop high speed Fourier Domain mode locked swept laser based anatomic OCT (FD-A-OCT) system to achieve real-time 3D imaging of up airway. The broad long-term objective of this proposal is to develop DNS driven simulations of upper airway airflow in tandem with high-speed 3D FD-A-OCT as a means to: 1) image upper airway anatomy in awake children; and then 2) simulate the flow of air in the upper airway to gain information on flow, pressure, and turbulence. This model development and in vivo measurement technology aims to ultimately improve accuracy in selecting patients for and predicting the response to surgery. This proposal integrates expertise in optical coherence tomography (Chen), device design (Wong), computational fluid dynamics (Elghobashi, Pollard, Kimbell), and clinical expertise (Wong, Rhee, Ahuja) to develop a system to generate real-time 3-D volumetric images of the internal airway structure and estimate airflow dynamics in children. The structural information on internal airway anatomy will allow simulation of upper airway airflow and estimation of the impact of surgery on relieving airway obstruction. In turn, the model will provide a means to determine which children will benefit from upper airway surgery, and is a first step toward developing individualized surgical therapy. The development and rapid translation of patient specific geometry to CFD modeling, will set the stage for pre-surgical planning/interventional surgery. PUBLIC HEALTH RELEVANCE: Project Narrative Upper airway obstruction is a major problem in children, and identifying the anatomic location of airway collapse is difficult. Development of an office-based treatment technology to image the upper airway in awake children, and then compute airflow accurate would decrease morbidity and reduce health care costs. (End of Abstrct)

描述（由申请人提供）：使用解剖光学相干断层扫描和计算流体动力学（DNS）项目摘要上呼吸道障碍物对小儿上呼吸道进行建模，这是一个影响所有儿童3％的问题。该问题是多因素的，包括解剖和神经肌肉元素。上呼吸道阻塞的最常见原因与腺刺肥大有关。腺孔切除术（AT）是美国执行的最常见的手术之一，每年约有60万名儿童。在减轻绝大多数儿童的症状气道阻塞方面有显着改善；仍然有大量儿童从这种治疗中受益，在颅面异常，唐氏综合症和肥胖症的儿童中尤其如此。确定在手术前未能反应的儿童非常具有挑战性。该建议是对RFA-HL-10-017的响应，旨在开发和验证新的建模和体内测量工具，用于评估/预测儿童上呼吸道功能障碍。集成的多中心国际团队将使用直接数值模拟模型来开发计算模型，以识别在小儿上空气道中产生气流限制的生物学和结构组件。为了提供用于建模的体内结构数据，我们将开发高速傅立叶模式锁定扫描激光的解剖OCT（FD-A-OCT）系统，以实现UP AIRWAIN的实时3D成像。该提案的广泛长期目标是与高速3D FD-A-OCT一起开发DNS驱动的上部气道气流的模拟。然后2）模拟上呼吸道中的空气流以获取有关流动，压力和湍流的信息。该模型开发和体内测量技术旨在最终提高选择患者并预测手术反应的准确性。该建议将光学相干断层扫描（CHEN），设备设计（Wong），计算流体动力学（Elghobashi，Pollard，Kimbell）和临床专业知识（Wong，Wong，Rhee，Ahuja）的专业知识整合在一起，以开发一个系统以生成实时3-D体积图像的内部空气和估计动力学的实时3-D体积图像。有关内部气道解剖结构的结构信息将允许模拟上气道气流，并估算手术对缓解气道阻塞的影响。反过来，该模型将提供一种方法来确定哪些儿童将从上呼吸道手术中受益，这是迈向发展个性化手术疗法的第一步。患者特异性几何形状向CFD建模的发展和快速翻译将为手术前的计划/介入手术奠定基础。公共卫生相关性：项目叙事上的呼吸道阻塞是儿童的主要问题，并且很难确定气道崩溃的解剖位置。开发基于办公室的治疗技术，以对清醒儿童的上呼吸道进行成像，然后计算气流准确的水流将降低发病率并降低医疗保健成本。 （Abstrct的结尾）