Contrast-enhanced subharmonic aided pressure estimation for assessment of intracranial pressure in vivo.
Contrast-enhanced subharmonic aided pressure estimation for assessment of intracranial pressure in vivo.
复制标题
对比增强次谐波辅助压力估计，用于评估体内颅内压。
DOI：
10.1007/s00247-023-05637-2
复制
发表时间：
2023
影响因子：
2.3
通讯作者：
Didier,RyneA
中科院分区：
文献类型：
--
作者：
Larson,AbbyC;Sridharan,Anush;Moon,JamesK;Agarwal,Divyansh;Chang,Jonathan;Wallace,KirkD;Forsberg,Flemming;Didier,RyneA
背景目前，儿童的颅内压监测需要有创的技术。亚谐波辅助压力估计法(SHAPE)利用超声造影(CEUS)测量血管内和间质内的压力，但在测量颅内压方面的应用还没有被探索。目的本研究的目的是探讨SHAPE作为一种新的无创性测量胎羊颅内压的工具。材料和方法18只孕107~139日龄(足 = 145日龄)的胎羔行硬膜下ICP导管置入术。在针对形状优化的CEUS模式下，大脑在冠状平面上成像，同时向胎儿循环中注入超声造影剂。形状校正后，经硬膜下导管注入生理盐水以增加颅内压。在不同的ICP上获得5秒的形状电影剪辑。用混合效应线性回归分析全脑和丘脑的亚谐强度与ICP值之间的关系，并用Spearman的秩次相关来评估这种关系的强度。结果49个实验产生了723个数据点，包括形状光强值和平均ICP值。在动物模型中，全脑和丘脑的形状强度值与颅内压测量值呈显著负相关(中位数Rho值分别为 − 0.5 8和 − 0.5 6)。
BackgroundIntracranial pressure (ICP) monitoring in children currently requires invasive techniques. Subharmonic aided pressure estimation (SHAPE) uses contrast-enhanced ultrasound (CEUS) to measure intravascular and interstitial pressure, but utility in ICP measurements has yet to be explored.ObjectiveThe objective of this study was to investigate SHAPE as a novel tool for noninvasive ICP measurements in fetal lambs.Materials and methodsEighteen fetal lambs at 107–139 days gestational age (term = 145 days) underwent subdural ICP catheter placement. The brain was imaged in the coronal plane in CEUS mode optimized for SHAPE, while infusing an US contrast agent into the fetal circulation. After SHAPE calibration, saline was infused via the subdural catheter to increase ICP. Five-second SHAPE cine clips were obtained at various ICPs. Subharmonic intensity values of the whole brain and thalami were correlated with ICP values using mixed effects linear regression analyses and the strength of the relationship was evaluated by Spearman’s rank-order correlation.ResultsForty-nine experiments produced 723 datapoints, including SHAPE intensity values and mean ICP measurements. There was a statistically significant inverse relationship between SHAPE intensity values and ICP measurements in the whole brain and thalami (median rho value − 0.58 and − 0.56, respectively).ConclusionSHAPE intensity values of the brain demonstrate an inverse and statistically significant correlation with in vivo ICP measurements in an animal model.