Wearable Electrostrictive Row-Column Ultrasound Arrays for Longitudinal Echocardiography

用于纵向超声心动图的可穿戴电致伸缩行列超声阵列

• 批准号: 10354880
• 负责人: Roger J Zemp
• 金额: $ 16.2万
• 依托单位: UNIVERSITY OF ALBERTA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-18 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10354880
• 关键词: 3-Dimensional; 3D ultrasound; Acoustics; Address; Adhesives; Algorithms; Ambulatory Monitoring; Area Under Curve; Arrhythmia; Arterial Lines; Atrial Fibrillation; Back; Beds; Biochemical; Blood Pressure; Cardiac Output; Cardiogenic Shock; Cardiovascular system; Catheters; Clinical; Coupling; Data; Deposition; Development; Diagnosis; Disadvantaged; Discipline; Doppler Ultrasound; EFRAC; Echocardiography; Electrodes; Electronics; Elements; Environment; Evaluation; Excision; Family suidae; Gel; Gold; Hand; Heart; Histopathology; Human; Hypotension; Image; Imagery; Intensive Care; Intensive Care Units; Label; Left; Lesion; Lung; Manuals; Measurement; Measures; Medicine; Metabolism; Methodology; Methods; Microscopy; Modality; Monitor; Nature; Operative Surgical Procedures; Outpatients; Patient imaging; Patients; Pattern; Pharmaceutical Preparations; Physiologic pulse; Polychlorinated Biphenyls; Positioning Attribute; Pulmonary Hypertension; Pulmonary artery structure; Pump; Regimen; Research; Resolution; Risk; Scanning; Scheme; Shock; Side; Skin; Specimen; Speed; Surgical Oncology; System; Techniques; Technology; Testing; Thermodilution; Three-Dimensional Imaging; Time; Time trend; Tissues; Transducers; Tricuspid Valve Insufficiency; Ultrasonography; Venous; base; breast lumpectomy; cardiovascular imaging; design; diagnostic platform; electric impedance; first-in-human; heart function; heart imaging; hemodynamics; human imaging; hypoperfusion; imaging capabilities; imaging modality; improved; minimally invasive; non-invasive monitor; novel; point of care; pressure; programs; pulmonary arterial pressure; remote sensing; serial imaging; ultrasound; ultraviolet; vascular injury; voltage

Project Summary / Abstract In patients admitted to intensive care units (ICUs) with shock (low blood pressure) that results in both clinical and biochemical evidence of tissue hypoperfusion due to inadequate cardiac output, clinicians commonly seek to assess and monitor cardiac function, but all available invasive and non-invasive methodologies have significant limitations and/or risk. The gold standard method to assess cardiac output and shock states is a pulmonary arterial catheter (PAC) which is inserted through a venous canula and passes through the right side of the heart into the pulmonary artery. The advantages of this modality are that it provides information on right and left heart pressures, and allows for the calculation of cardiac output via thermodilution techniques. Its disadvantages include the invasive nature resulting the potential risk of vascular injury. Moreover, cardiac outputs are inaccurate in common cardiac arrhythmias (ex atrial fibrillation) and valvular lesions (ex tricuspid regurgitation), and only provides information on overall cardiac function without direct information on left and right heart function. Non-invasive cardiac output monitors (NICOMs) use proprietary bio-impedance or arterial line area under the curve algorithms to estimate cardiac output. While these are minimally invasive, they have not been well validated in patients in cardiogenic shock and provide no information on left and right heart function. Finally, point of care ultrasound (POCUS) allows echocardiographic evaluation of left and right heart function, but it is not well suited for evaluation of continuous or temporal trends in cardiac function given it requires a clinician to acquire images at the bedside. A wearable ultrasound probe that would enable hands-free longitudinal imaging of patients would prove to be of considerable value in the ICU environment. In this proposal we introduce a radically new wearable ultrasound technology, bias-sensitive electrostrictive top- orthogonal-to-bottom electrode (TOBE) arrays. These TOBE arrays offer readout from every element of a 2D array through biasing control and transmit-receive control of only rows and columns, rather than require wiring from every element. With novel readout approaches, these arrays will be demonstrated to achieve image quality comparable to a linear array, but with full electronic 3D scanning capabilities. Unlike MATRIX probes that rely on complicated micro-beamformers, our approach is simpler, yet allows for advanced imaging modes such as ultrafast imaging at thousands of frames per second. We propose the development of such ultrafast imaging modes with wearable TOBE probes for angle-agnostic flow estimation and longitudinal electronic tracking of right and left heart function. The angle-agnostic flow estimation avoids errors due to unknown Doppler angles and mitigates the need for manual probe positioning. In this proposal, we aim to further develop the transducer technology, interfacing electronics, and imaging methods to enable angle-agnostic flow imaging in phantoms, then with first-in-human imaging. We aim to establish feasibility data for future research into advanced longitudinal monitoring of cardiac output, ejection fractions, pulmonary artery pressure, etc.

项目摘要 /摘要 在患有震动（低血压）重症监护病房（ICU）的患者中，这两种临床 以及由于心脏输出不足而导致的组织灌注不足的生化证据，临床医生通常寻求 评估和监测心脏功能，但所有可用的侵入性和无创方法都有 重大限制和/或风险。评估心输出和冲击状态的黄金标准方法是 肺动脉导管（PAC）通过静脉can插入并通过右侧 心脏进入肺动脉。这种方式的优点是它提供了正确的信息 和左心压，并允许通过热氧化技术计算心脏输出。它是 缺点包括侵入性，导致血管损伤的潜在风险。而且，心脏 输出不准确，心脏心律不齐（事前的纤颤）和瓣膜病变（Ex Tricuspid 反流），仅提供有关整体心脏功能的信息，而无需直接信息， 右心功能。非侵入性心输出监测器（NICOMS）使用专有生物阻抗或动脉 曲线算法下的线面积以估计心输出量。虽然这些是最少的侵入性，但它们有 心脏病性休克患者的验证尚未得到很好的验证，并且在左右心脏功能上没有提供任何信息。 最后，护理点超声（POCUS）允许对左右心脏功能的超声心动图评估， 但是它不适合评估心脏功能的连续或时间趋势，因为它需要 临床医生在床边获取图像。可穿戴的超声探针，可以免提 在ICU环境中，对患者的纵向成像被证明具有相当大的价值。 在此提案中，我们引入了一种根本新的可穿戴超声技术，对偏见的电扭曲的顶级技术 正交到底电极（TOBE）阵列。这些TOBE数组提供了2D的每个元素的读数 通过偏置控制和传输对行的偏置控制和列的阵列，而不是需要接线 来自每个元素。采用新颖的读数方法，这些阵列将被证明以达到图像质量 与线性阵列相当，但具有完整的电子3D扫描功能。与依赖的矩阵探针不同 在复杂的微型光束图中，我们的方法更简单，但允许高级成像模式（例如 超快成像，每秒成千上万帧。我们提出了这种超快成像的发展 具有可穿戴tobe探针的模式，用于角度 - 不合骨流量估计和右纵向电子跟踪 并左心功能。角度不合时式流量估计避免了由于未知的多普勒角和 减轻对手动探针定位的需求。在此提案中，我们旨在进一步发展传感器 技术，接口电子和成像方法，以启用幻影中的角度流动成像， 然后使用第一个人类成像。我们旨在建立可行性数据，以供未来研究 对心脏输出，射血分数，肺动脉压力等的纵向监测等。