Transcranial Ultrasound Algorithms and Device for Rapid Stroke Determination by Paramedics

用于医护人员快速确定中风的经颅超声算法和设备

基本信息

批准号：
10730722
负责人：
Carl Herickhoff
金额：
$ 41.38万
依托单位：
UNIVERSITY OF MEMPHIS
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-07-01 至 2026-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10730722
关键词：
3-Dimensional Accounting Acoustics Algorithm Design Algorithms Ambulatory Care Animal Model Anterior Area Arteries Biomedical Engineering Biomedical Research Blood Blood Vessels Blood flow Brain Cardiovascular Diseases Cardiovascular system Caring Catheterization Cause of Death Cephalic Certification Cessation of life Clinical Clinical Skills Collaborations Country Custom Data Data Analyses Dependence Detection Device Designs Devices Diagnosis Doppler Ultrasound Embolism Environment Equipment Future Geometry Goals Health care facility Healthcare Systems Hemorrhage Hospitals Hour Human Image Institution Intervention Ischemia Ischemic Stroke Location Maps Measurement Measures Mechanics Mentors Mentorship Modeling Monitor Morbidity - disease rate Neurologic Neurologist Outcome Paramedical Personnel Patients Performance Property Publishing Research Research Personnel Research Project Grants Resolution Sampling Signal Transduction Stroke Structure of posterior cerebral artery Students Subarachnoid Hemorrhage System Techniques Testing Thick Thrombectomy Time Transcranial Doppler Ultrasonography Transducers Triage Ultrasonic Therapy Ultrasonography Universities Vascular blood supply Vasospasm attenuation bone brain tissue brain volume cerebrovascular computerized data processing cost cost effective cranium design digital disability experience experimental study fabrication graduate student improved in vivo in vivo evaluation intracranial artery machine learning algorithm mortality nervous system disorder novel operation peer prototype quantitative ultrasound rapid detection research clinical testing role model simulation stroke outcome success trend ultrasound undergraduate research undergraduate student usability user-friendly vector

项目摘要

Project Summary/Abstract Timely diagnosis of stroke (ischemic vs. hemorrhagic) is critical to streamlining appropriate treatment and achieving optimal clinical outcomes–minimizing damage to brain tissue and function. About 87% of strokes are ischemic, with large vessel occlusions (LVOs) accounting for >90% of deaths among this subset. Patients with LVOs are best treated with mechanical thrombectomy at a certified comprehensive stroke center (CSC) hospital as soon as possible, but the nearest non-CSC stroke-care facility may lack this interventional catheterization capability. Transcranial Doppler (TCD) ultrasound can measure vascular flow and detect LVOs, but current TCD equipment has high operator dependence: to acquire a TCD signal, the user must simultaneously find the optimal “acoustic window” of a patient’s skull and precisely align the ultrasound beam with the middle, anterior, or posterior cerebral arteries. We propose to design a transcranial ultrasound device that enables paramedics to identify LVOs quickly and easily as part of stroke triage, to reduce the time to tPA and thrombectomy treatment delivery (by tens of minutes to >1 hour) and improve ischemic stroke outcomes. This new TCD device will include a customized 2D transducer array that can (1) sample and map trends in acoustic properties over an area of the skull and (2) detect angled wavefronts from moving blood scatterers within the beam. To achieve this design, our team–consisting primarily of undergraduates–will take thorough experimental acoustic measurements of ex vivo skull, acquire transskull Doppler measurements on a custom phantom using a commercial array probe, and perform transskull simulations of unique transducer array geometries. These efforts will pinpoint ideal acoustic windows and yield a high-resolution, digital acoustic model of temporal skull, provide signals from which to refine an algorithm to guide the placement and angle of a TCD transducer, and ultimately optimize the layout and operation of a custom 2D array streamlined for TCD acquisition (and LVO detection) by untrained users. This project will lead to further research (prototype fabrication and in vivo testing) and applications in detecting and monitoring various neurological and cardiovascular conditions. Long-term, we envision cost-effective, user- friendly TCD used in ambulatory care units across the country, and improved transcranial imaging and therapy capabilities as well. The project will provide a closely mentored biomedical research experience to a diverse set of undergraduates, whose success as researchers and role models will significantly impact and enhance the research environment at the University of Memphis and collaborating institutions across the Mid-South.

项目概要/摘要及时诊断中风（缺血性与出血性）对于简化适当的治疗和治疗至关重要实现最佳临床结果——最大限度地减少对脑组织和功能的损害约 87% 的中风是中风。缺血性，大血管闭塞 (LVO) 占该亚组患者死亡人数的 90% 以上。 LVO 的最佳治疗方法是在经过认证的综合性卒中中心 (CSC) 医院进行机械血栓切除术尽快，但最近的非 CSC 中风护理机构可能缺乏这种介入导管插入术经颅多普勒 (TCD) 超声可以测量血管流量并检测 LVO，但目前的 TCD 设备对操作员的依赖性较高：要获取 TCD 信号，用户必须同时找到最佳的患者头骨的“声学窗口”，并将超声波束与中、前或后部精确对齐脑动脉。我们建议设计一种经颅超声设备，使护理人员能够快速识别 LVO 并轻松作为中风分诊的一部分，以减少 tPA 和血栓切除术治疗交付的时间（减少数十分钟到 > 1 小时）并改善缺血性中风结果。这种新的 TCD 设备将包括定制的 2D。换能器阵列，可以 (1) 对头骨区域的声学特性进行采样并绘制趋势图，以及 (2) 进行检测光束内移动的血液散射体产生的倾斜波前为了实现这一设计，我们的团队组成。主要是本科生——将对离体头骨进行彻底的实验声学测量，获取使用商业阵列探头在定制体模上进行跨颅多普勒测量，并执行跨颅对独特换能器阵列几何形状的模拟将精确定位声学理想窗口并产生一个颞颅骨的高分辨率数字声学模型，提供信号来改进指导算法 TCD 传感器的位置和角度，并最终优化定制 2D 的布局和操作阵列经过简化，可供未经培训的用户进行 TCD 采集（和 LVO 检测）。该项目将导致进一步的研究（原型制造和体内测试）和检测应用从长远来看，我们设想具有成本效益的、用户友好的。友好的 TCD 在全国各地的门诊护理单位中使用，并改进了经颅成像和治疗该项目还将为多元化的人提供密切指导的生物医学研究经验。一群本科生，他们作为研究人员和榜样的成功将极大地影响和增强孟菲斯大学和中南部合作机构的研究环境。