Reading workstation for clinical contrast echocardiography

临床造影超声心动图读取工作站

• 批准号: 10155647
• 负责人: Brian Perez Davidson
• 金额: $ 25.24万
• 依托单位: NARNAR, LLC
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-03-01 至 2022-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10155647
• 关键词: Address; Adoption; Algorithms; American; Anatomy; Angiography; Apical; Benign; Blood; Blood Flow Velocity; Cardiac; Cardiomyopathies; Cardiovascular system; Chest Pain; Classification; Clinical; Clinical Research; Clip; Code; Color; Computer Assisted; Computer software; Computers; Contrast Echocardiography; Contrast Media; Coronary; Coronary Arteriosclerosis; Data; Diagnosis; Diagnostic; Disease; Echocardiography; Engineering; Evaluation; Event; Eye; Female; Guidelines; Image; Imaging Techniques; Machine Learning; Mechanics; Medical; Methods; Microcirculation; Microvascular Dysfunction; Myocardial; Myocardial Ischemia; Myocardial perfusion; Names; Patients; Performance; Perfusion; Phase; Physicians; Process; Radial; Reader; Reading; Recommendation; Rest; Scientist; Side; Societies; Software Engineering; Standardization; Stress; Syndrome; Techniques; Technology; Thick; Time; Training; Ultrasonography; Vendor; Visual; arteriole; base; clinical Diagnosis; endothelial dysfunction; image processing; imaging software; indexing; multidisciplinary; neural network; novel; parametric imaging; perfusion imaging; prognostic; programs; sample archive; single photon emission computed tomography; standard of care; tool; user-friendly

Proposal Summary There is increasing appreciation of a syndrome in which patients female patients, present with chest pain due to myocardial ischemia and have a normal or near normal coronary angiogram. Termed coronary microvascular dysfunction (MVD) this disorder is not benign with cardiovascular event rates similar to those with established coronary artery disease. Clinical tools are therefore needed to both identify MVD patients and better understand the mechanisms causing myocardial ischemia. There is evidence that myocardial contrast echocardiography (MCE) provides incremental information in the evaluation of patients with coronary artery disease, myocardial viability, or diseases of the microvasculature. Despite data demonstrating the diagnostic and prognostic benefit of MCE in evaluating patients with MVD, its clinical use has been limited to only a handful of experts in the field, because there are currently no widely available clinical tools to support MCE quantitative analysis and interpretation. The overall aim of this Phase I proposal is to provide clinicians with a new tool to evaluate the myocardial flow-function relationship that is critical to identifying patients with MVD by using echocardiography. We will develop clinical software that can rapidly process MCE data into a standardized, quantitative and easy- to- interpret format. In Aim 1, the power of image averaging and computer aided assessment of radial wall thickening will be used to enhance the current standard of care which relies solely on readers' visual estimation of segmental function. An algorithm will be developed to rearrange the order of images so that images representing the same phase of the cardiac cycle are grouped together. Functional analysis will then be developed using computer-aided tracings of epicardial and endocardial borders. In Aim 2, a software module for quantitative analysis of real-time MCE perfusion will be developed that will incorporate statistical confidence, derived from the performance of image processing algorithms to inform the interpreter about the data strength. Machine learning will be utilized to train and deploy a neural network for the pixel-by-pixel assessment of myocardial perfusion. In Aim 3, we will combine myocardial perfusion and function modules into a novel, perfusion-function mode of imaging (PF-mode). This new mode will be applied to an archival sample of clinically diagnosed MVD cases to demonstrate the feasibility to detect abnormalities in the myocardial flow-function relationship. The composite PF-mode will include a cine-loop rendered for one cardiac cycle where parametric images (perfusion) are superimposed over averaged ultrasound images with an overlay of graphic representation of wall thickness (function). This novel mode of imaging provides the means to diagnose MVD in a single clinical study.

提案摘要 人们对综合征的理解越来越多，其中患者患有胸部的患者 由于心肌缺血引起的疼痛，并具有正常或接近正常的冠状动脉造影。称为 冠状动脉微血管功能障碍（MVD）这种疾病与心血管事件发生率不是良性的 与已建立冠状动脉疾病的人相似。因此，两者都需要临床工具 识别MVD患者，并更好地了解引起心肌缺血的机制。有 心肌对比超声心动图（MCE）提供了增量信息的证据 评估冠状动脉疾病，心肌生存力或疾病的患者 微脉管系统。尽管数据证明了MCE在 评估MVD患者的临床用途仅限于该领域的少数专家， 因为目前尚无广泛可用的临床工具来支持MCE定量分析和 解释。我提出的这一阶段的总体目的是为临床医生提供新工具 评估心肌流动关系，这对于识别MVD患者至关重要 使用超声心动图。我们将开发可以快速将MCE数据处理到一个的临床软件 标准化，定量和易于解释格式。在AIM 1中，图像平均的力量和 径向壁厚的计算机辅助评估将用于增强当前的护理标准 这仅依赖于读者对分段函数的视觉估计。将开发出一种算法 重新排列图像的顺序，以使代表心脏周期相同阶段的图像为 分组在一起。然后将使用心外膜的计算机辅助示踪来开发功能分析 和心内膜边界。在AIM 2中，用于实时MCE定量分析的软件模块 将开发灌注，将纳入统计信心，从 图像处理算法以告知口译员有关数据强度的信息。机器学习将是 用于训练和部署神经网络，用于逐个像素的心肌灌注评估。 在AIM 3中，我们将心肌灌注和功能模块结合到新颖的灌注功能中 成像模式（PF模式）。这种新模式将应用于临床诊断的档案样本 MVD病例以证明检测心肌流动异常的可行性 关系。复合PF模式将包括一个用于一个心脏周期的Cine环，其中 参数图像（灌注）被叠加在平均超声图像上 壁厚的图形表示（功能）。这种新颖的成像模式提供了 在一项临床研究中诊断MVD。