Optimization of Dialysis Fistula Maturation via Vascular Ultrasound Elasticity an

通过血管超声弹性和优化透析瘘成熟

基本信息

批准号：
8732651
负责人：
William F Weitzel
金额：
$ 18.36万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-09-15 至 2016-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8732651
关键词：
Algorithms Anatomy Angioplasty Architecture Arteries Arteriovenous fistula Blood Blood Vessels Blood flow Caliber Cardiac Catheters Clinical Clinical Research Clinical Trials Communication Complication Computer software Data Diagnostic Diagnostic Procedure Dialysis procedure Early Intervention Elasticity Failure Fistula Foundations Frequencies Future Gelatin Geometry Goals Grant Guidelines Health Services Accessibility Hemodialysis Image Imaging Device In Vitro Incidence Intervention Investigation Kidney Link Longevity Manufacturer Name Measurement Measures Mechanics Medical Medicine Methods Metric Multi-Institutional Clinical Trial Nature Operative Surgical Procedures Outcome Patients Physiological Pilot Projects Postoperative Period Prevalence Procedures Property Protocols documentation Public Domains Pulsatile Flow Radio Research Research Personnel Resolution Risk Sampling Second Look Surgery Software Tools Stimulus Stress Study Subject System Techniques Time Tissues Translating Ultrasonography Uncertainty United States National Institutes of Health Vascular remodeling Veins Velocimetries Venous abstracting base cost digital imaging elastography file format fluid flow hemodynamics image processing improved in vivo interest meetings particle public health relevance research study signal processing success tool

项目摘要

DESCRIPTION (provided by applicant): Optimization of Dialysis Fistula Maturation via Vascular Ultrasound Elasticity and Shear Rate Imaging R21: NIH PI: William Weitzel, MD Co-I: Albert Shih, PHD, Grant Kruger, Matthew Leavitt, Peter Henke Abstract Vascular access is crucial to the treatments necessary for hemodialysis patients. Due to their reliability, longevity, and lower complication rates, autogenous arteriovenous fistulas - surgically created connections between arteries and veins - have become increasingly prominent over other forms of vascular access. However, the uncertainty associated with fistula maturation has caused undue cost, risk, and stress to patients already undergoing significant medical procedures. Currently no system exists to directly and noninvasively measure the underlying causes of vascular remodeling during fistula maturation. We propose to build an ultrasound software toolbox - referred to as the vascular ultrasound elastography and shear rate (VUESR) imaging - that has unprecedented temporal and spatial resolution to identify vessel wall edges and measure vessel size, elastic properties, and blood-wall shear rate during the cardiac cycles. After validating thi tool both in vitro (through phantom studies on simple and realistic fistula geometries) and in vivo (a pilot study conducted on a small sample of hemodialysis patients pre- and post-fistula creation), we plan to release the software necessary for this technique available in the public domain as an open platform tool for researchers. This software tool will be useful for pre-operative planning and post-operative assessment to guide decisions for angioplasty and surgical revision. Given the ubiquity and noninvasive nature of ultrasound imaging and the broad open access with which we plan to release this tool, this proposal can radically accelerate safe and effective ultrasound diagnostic methods for fistula optimization.

描述（由申请人提供）：通过血管超声弹性和剪切速率成像R21：NIH PI：William Weitzel，MD Co-I：Albert Shih，博士，Grant Kruger，Matthew Leavitt，Matthew Leavitt，Peter Henke Abstract血管访问是至关重要的。由于它们的可靠性，寿命，以及较低的并发症发生率，自源动静脉瘘 - 在动脉和静脉之间建立的连接 - 在其他形式的血管通道中变得越来越突出。但是，与瘘管成熟相关的不确定性导致已经接受大量医疗程序的患者导致了不当成本，风险和压力。目前，尚无系统直接和非侵入性测量瘘管成熟过程中血管重塑的根本原因。我们建议构建一个超声软件工具箱 - 称为血管超声弹性图和剪切速率（VUESR）成像 - 它具有前所未有的时间和空间分辨率，以识别容器壁边缘并测量船只的大小，弹性性能，弹性性能，弹性性能，以及在心脏循环期间的血液毛壁剪切速率。在验证了体外（通过对简单和逼真的瘘管几何形状的幻影研究）和体内验证该工具后（一项针对少量血液透析患者样本的试点研究），我们计划释放公共领域可用的该技术所需的软件，作为研究人员的开放平台工具。该软件工具将用于术前计划和术后评估，以指导血管成形术和手术修订的决策。鉴于超声成像的普遍性和无创性，以及我们计划释放此工具的广泛开放访问，该建议可以从根本上加速安全有效的超声诊断方法，以进行瘘管优化。