Advanced acoustic field measurements of shock wave lithotripters

冲击波碎石机的先进声场测量

• 批准号: 7760534
• 负责人: Jeffrey Ketterling
• 金额: $ 22.71万
• 依托单位: RIVERSIDE RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-02-01 至 2012-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7760534
• 关键词: Acoustics; Address; Adult; Boston; CHRM3 gene; Calculi; Calibration; Clinical; Complex; Device Designs; Device or Instrument Development; Devices; Dimensions; Electrodes; Electromagnetics; Elements; Ensure; FDA approved; Failure; Frequencies; Future; Goals; Gold; Image; Incidence; Indium; Injury; Intervention; Kidney; Kidney Calculi; Laboratories; Length of Stay; Lithotripsy; Location; Marketing; Measurement; Measures; Medical; Membrane; Methods; National Institute of Diabetes and Digestive and Kidney Diseases; Outcome; Patients; Pattern; Performance; Process; Property; Safety; Shock; System; Techniques; Testing; Theoretical model; Tissues; Transducers; Translating; Trauma; Ultrasonography; Universities; Ureter; Variant; Washington; Work; aged; base; clinical efficacy; design; improved; in vivo; novel; operation; physical process; pressure; public health relevance; research study; simulation; sound; standard care

DESCRIPTION (provided by applicant): The goal of this project is to measure the instantaneous acoustic field of shock wave lithotripters (SWL) using a linear hydrophone array. All previous measurements of SWL acoustic fields have been performed with single-element hydrophones which are only effective if the sound field does not vary from shock to shock. Specifically, we propose to 1) fabricate linear hydrophone arrays based on techniques developed for high-frequency imaging arrays, 2) characterize the arrays electrically and acoustically, 3) drive the arrays to failure to determine durability, and 4) test the arrays in SWL devices to improve the understanding of the instantaneous acoustic field. The proposed measurements would represent the first instantaneous "snapshot" of an SWL acoustic field and would have broad implications for lithotripter device design, theoretical models of stone fragmentation, device calibration, and patient management. SWL has been employed for nearly 25 years to non-invasively treat kidney stones and is utilized in H 50% of the treatments when medical intervention is required. According to the National Institute of Diabetes and Digestive and Kidney Diseases, 5.2% of adults aged 20 to 74 have had kidney stones and H 171,000 adults require a hospital stay each year to undergo treatment of "calculus of kidney and ureters." Even though "improved" SWL systems have come to market, the original Dornier HM3 is still considered the gold standard in treatment. However, the acoustic field of the HM3, when measured at a single point, varies by as much as 50%. This variation is thought to improve stone fragmentation but it also increases the likelihood of trauma to the surrounding kidney tissue. The proposed linear hydrophone array will be fabricated at RRI by Dr. Ketterling. The initial array design will have 20 elements and span 18 mm. After validating the basic operation of the array at RRI, additional arrays will be fabricated and sent to Dr. Cleveland at Boston University and Dr. Bailey at the University of Washington. The arrays will then be employed to make the first instantaneous acoustic field measurements of the three major classes of SWL systems: electrohydraulic, electromagnetic, and piezoelectric lithotripters. The measurements will yield important information about the dimensions and peak pressure location of the instantaneous acoustic field, the effect on the acoustic field of different reflectors, and the performance of new versus old electrodes. A successful outcome of this project will, ultimately, help improve clinical efficacy through more efficient stone fragmentation and improve clinical safety by reducing tissue damage. PUBLIC HEALTH RELEVANCE: The ultimate goal of this work is to improve the efficacy of shock wave lithotripsy (SWL) treatment of kidney stones by more efficiently fragmenting the stones while exposing the surrounding kidney tissue to minimal trauma. The proposed measurements would represent the first instantaneous acoustic field measurements of SWL systems and would provide valuable information that could be used to improve lithotripter devices, theoretical models of stone fragmentation, device calibration, and patient management.

描述（由申请人提供）：该项目的目标是使用线性水听器阵列测量冲击波碎石机（SWL）的瞬时声场。之前所有的 SWL 声场测量都是使用单元件水听器进行的，只有当声场不会因冲击而变化时才有效。具体来说，我们建议 1) 基于高频成像阵列开发的技术制造线性水听器阵列，2) 表征阵列的电气和声学特性，3) 驱动阵列失效以确定耐久性，4) 在 SWL 中测试阵列提高对瞬时声场的理解的设备。所提出的测量将代表 SWL 声场的第一个瞬时“快照”，并将对碎石机设备设计、结石破碎理论模型、设备校准和患者管理产生广泛影响。 SWL 已用于非侵入性治疗肾结石近 25 年，并且在需要医疗干预时用于 50% 的治疗。根据国家糖尿病、消化和肾脏疾病研究所的数据，20至74岁的成年人中有5.2%患有肾结石，每年有171,000名成年人需要住院接受“肾脏和输尿管结石”的治疗。尽管“改进的”SWL 系统已经上市，最初的多尼尔 HM3 仍然被认为是治疗的黄金标准。然而，在单点测量时，HM3 的声场变化高达 50%。这种变化被认为可以改善结石破碎，但也增加了周围肾组织受伤的可能性。拟议的线性水听器阵列将由 Ketterling 博士在 RRI 制造。最初的阵列设计将有 20 个元件，跨度为 18 毫米。在 RRI 验证阵列的基本操作后，将制造更多阵列并发送给波士顿大学的克利夫兰博士和华盛顿大学的贝利博士。然后，这些阵列将用于对三大类 SWL 系统进行首次瞬时声场测量：电动液压碎石机、电磁碎石机和压电碎石机。测量结果将产生有关瞬时声场的尺寸和峰值压力位置、不同反射器对声场的影响以及新电极与旧电极性能的重要信息。该项目的成功最终将有助于通过更有效的碎石来提高临床疗效，并通过减少组织损伤来提高临床安全性。公共健康相关性：这项工作的最终目标是通过更有效地碎石同时使周围肾组织受到最小的创伤来提高冲击波碎石术 (SWL) 治疗肾结石的疗效。所提出的测量将代表 SWL 系统的首次瞬时声场测量，并将提供可用于改进碎石器设备、结石破碎理论模型、设备校准和患者管理的有价值的信息。