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

基本信息

批准号：
10610780
负责人：
Roger J Zemp
金额：
$ 13.5万
依托单位：
UNIVERSITY OF ALBERTA
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-04-18 至 2025-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10610780
关键词：
3-Dimensional 3D ultrasound Acoustics Address Adhesives Algorithms Ambulatory Monitoring Area Under Curve Arrhythmia Arterial Lines Atrial Fibrillation Beds Biochemical Blood Pressure Blood flow Cardiac Output Cardiogenic Shock Cardiovascular system Catheters Clinical Coupling Data Deposition Development Diagnosis Disadvantaged Discipline Doppler Ultrasound EFRAC Echocardiography Electrodes Electronics Elements Environment Esophagus Evaluation Excision Family suidae Gel Hand Heart Histopathology Human Hypotension Image Imagery Inpatients 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 Admission 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 breast lumpectomy cardiovascular imaging design diagnostic platform 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 skills transmission process ultrasound ultraviolet vascular injury voltage

项目摘要

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.

项目概要/摘要因休克（低血压）入住重症监护病房 (ICU) 的患者，导致临床症状以及由于心输出量不足导致的组织灌注不足的生化证据，临床医生通常会寻求评估和监测心脏功能，但所有可用的侵入性和非侵入性方法都已重大限制和/或风险。评估心输出量和休克状态的金标准方法是肺动脉导管 (PAC)，通过静脉插管插入并穿过右侧心脏进入肺动脉。这种方式的优点是可以提供正确的信息和左心压力，并允许通过热稀释技术计算心输出量。它是缺点包括侵入性导致血管损伤的潜在风险。此外，心脏常见心律失常（前房颤）和瓣膜病变（前三尖瓣）的输出不准确反流），仅提供整体心脏功能的信息，而没有左、右心脏功能的直接信息右心功能。无创心输出量监测仪 (NICOM) 使用专有的生物阻抗或动脉曲线下面积算法来估计心输出量。虽然这些是微创的，但它们尚未在心源性休克患者中得到充分验证，并且未提供有关左心和右心功能的信息。最后，护理点超声 (POCUS) 可以对左心和右心功能进行超声心动图评估，但它不太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。一种可穿戴式超声波探头，可实现免提操作患者的纵向成像将被证明在 ICU 环境中具有相当大的价值。在本提案中，我们引入了一种全新的可穿戴超声技术，即偏置敏感电致伸缩顶部- 正交底部电极（TOBE）阵列。这些 TOBE 阵列提供 2D 的每个元素的读数阵列通过偏置控制和仅行和列的发送-接收控制，而不需要布线从每一个元素。通过新颖的读出方法，这些阵列将被证明可以实现图像质量与线性阵列相当，但具有完整的电子 3D 扫描功能。与依赖于在复杂的微波束形成器上，我们的方法更简单，但允许高级成像模式，例如每秒数千帧的超快成像。我们建议开发这种超快成像具有可穿戴 TOBE 探头的模式，用于与角度无关的流量估计和右侧的纵向电子跟踪和左心功能。与角度无关的流量估计避免了由于未知的多普勒角度和减少了手动探头定位的需要。在本提案中，我们的目标是进一步开发传感器技术、接口电子设备和成像方法，以实现体模中与角度无关的血流成像，然后是首次人体成像。我们的目标是为未来的先进研究建立可行性数据纵向监测心输出量、射血分数、肺动脉压等。