Noninvasive Pressure Estimation Based on the Subharmonic Response of SonoVueTM: Application to Intracranial Blood Pressure assessment
Noninvasive Pressure Estimation Based on the Subharmonic Response of SonoVueTM: Application to Intracranial Blood Pressure assessment
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基于 SonoVueTM 次谐波响应的无创压力估计：在颅内血压评估中的应用
DOI：
10.1109/tuffc.2021.3138100
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Mingxi Wan
中科院分区：
文献类型：
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作者：
Xiaoyang Qiao;Yu Wen;Jianjun Yu;Ayache Bouakaz;Yujin Zong;Mingxi Wan
颅内血压可以直接实时反映血管的状态。然而，它只能在开颅术中使用微导管进行侵入性评估。亚谐波辅助压力评估（SHAPE）是一种很有前途的心脏压力评估技术，但主要使用索那唑类药物，而使用索那维的SHAPE仍处于早期发展阶段。本研究旨在通过研究亚谐波信号与大脑中动脉压（MCAP） （20 ~ 160 mmHg）的关系，利用SonoVue优化经颅SHAPE。我们研究了声输出水平（峰值负压为238、346和454 kPa）、悬浮时间（从重组悬浮到提取悬浮的时间：0-30分钟）和暴露于气平衡盐水（3分钟、1小时或原始气体完全被空气取代）对次谐波压力关系的影响。使用5 MHz 12周期脉冲提取0.4 MHz带宽上的平均次谐波幅度。当PNP为346 kPa时，在评估0.24 dB/mmHg的静水压力时，获得了最佳的次谐波灵敏度，这可能是因为在该压力下不再发生纯压缩行为。此外，膨胀力不足以抵消静水压力的影响。仅在刚制备的SonoVue中观察到次谐波振幅与静水压力之间的线性单调关系。过度暴露于气平衡盐水中也会影响次谐波压力关系。因此，应使用刚配制好的SonoVue，并严格控制压力估算过程的持续时间。
Intracranial blood pressure can directly reflect the status of blood vessels in real time. However, it can only be estimated invasively using a microcatheter during craniotomy. Subharmonic-aided pressure estimation (SHAPE) is a promising technique for estimating cardiac pressures but mainly uses Sonazoid, whereas SHAPE using SonoVue is still in the early stages of development. The aim of this study was to optimize transcranial SHAPE using SonoVue by investigating the relationship between subharmonic signals and middle cerebral artery pressure (MCAP) (20–160 mmHg)in vitro. We examined the effect of acoustic output levels (peak negative pressures (PNPs) of 238, 346, and 454 kPa), time in suspension (time from reconstituting the suspension to extracting it: 0–30 min), and exposure to gas-equilibrated saline (3 min, 1 h, or original gas completely replaced by air) on the subharmonic-pressure relationship. A mean subharmonic amplitude over a 0.4 MHz bandwidth was extracted using a 5 MHz 12-cycle pulse. A PNP of 346 kPa elicited the best subharmonic sensitivity for assessing hydrostatic pressures up to 0.24 dB/mmHg, possibly because compression-only behavior no longer occurs at this pressure. Moreover, the expansion force is not large enough to offset the effects of hydrostatic pressure. A linear monotonic relationship between the subharmonic amplitude and hydrostatic pressure was only observed for just prepared SonoVue. Excessive exposure to gas-equilibrated saline also affected the subharmonic-pressure relationship. Therefore, just prepared SonoVue should be used, and the duration of the pressure estimation process should be strictly controlled.