CAVITATION MONITORING AND CONTROL IN LITHOTRIPSY

碎石术中的空化监测和控制

• 批准号: 7493012
• 负责人: LAWRENCE A CRUM
• 金额: $ 37.93万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-07-01 至 2009-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7493012
• 关键词: Accounting; Acoustics; Agreement; Anesthetic Gases; Area; Benefits and Risks; Biological; Blood flow; CHRM3 gene; Calculi; Clinical; Detection; Devices; Disease; Doppler Ultrasound; Drops; Electromagnetics; Feedback; Fiber Optics; Free Radicals; Gases; General Population; Generations; Hemolysis; Image; Individual; Injury; Kidney; Kidney Calculi; Knowledge; Laboratories; Lithotripsy; Localized; Manufacturer Name; Measures; Modeling; Monitor; Pathway interactions; Physical condensation; Physiologic pulse; Play; Production; Pulse taking; Radiation; Recommendation; Research Personnel; Role; Safety; Shock; Site; Solubility; Stress; System; Techniques; Testing; Time; Tissues; Ultrasonography; design; detector; discount; evaporation; hemodynamics; improved; in vivo; innovation; interest; pressure; programs; research study; sensor; simulation; vapor; vasoconstriction; vibration

Shock wave lithotripsy (SWL) is the treatment of choice for renal stone disease and has been a widely accepted and effective treatment. However, as manufacturers seek to deliver new and improved devices, they have generally migrated from units that produce broad focal volumes with moderately-high shock wave amplitudes to tight focal volumes with high shock wave amplitudes. This approach is intended to enhance stone comminution and reduce tissue injury. However, it appears that these manufacturers have discounted the role of cavitation in either stone comminution or tissue injury. Over the past several years, this PPG team has undertaken a broad and comprehensive study of both the physical and the biological mechanisms associated with SWL; this particular project has made considerable progress in examining the role of cavitation and find it to be the dominant mechanism of action. Although we have made much progress, there is still much that is not understood, and this proposal details our continued search to understand the physical mechanisms through which SWL can continue to provide a safe and effective treatment for stone disease. In order for our scientific progress to be optimized, we have concentrated on a general direction meant to transition our discoveries from the laboratory to the manufacturer. Accordingly, in this proposal we seek ways to improve the devices and the approaches to SWL and to disseminate to manufacturers and the general public specific recommendations for such improvements. To this end, our specific aims are summarized as follows: 1) to develop techniques and devices that would provide monitoring feedback on cavitation, blood flow, and stone comminution to clinicians in real-time 2) to use our dual-pulse lithotripter to test our hypothesis that localizing and intensifying the cavitation field will maximize comminution while minimizing tissue injury; 3) to determine whether lithotripter shock waves or the forces produced by cavitation cluster collapse produce the greatest stresses within the stone; 4) to measure the individual effects of the various components of the shock-wave waveform and from this knowledge, design an optimal waveform; and 5) to expand our cavitation model capability by introducing the effect of evaporation within the bubble, and from these studies, obtain estimates of the level of free radical production by SWL.

冲击波碎石疗法（SWL）是肾脏疾病的选择治疗，并且已被广泛接受且有效的治疗方法。但是，随着制造商寻求提供新的和改进的设备，它们通常是从产生宽阔的局灶性体积的单元中迁移的，具有中度高的冲击波幅度幅度为具有高冲击波幅度的紧密局灶性体积。这种方法旨在增强石材粉碎和减少组织损伤。但是，看来这些制造商在石材粉碎或组织损伤中均违反了空化的作用。在过去的几年中，该PPG团队对与SWL相关的物理和生物学机制进行了广泛而全面的研究。这个特定项目在研究 空化并发现它是作用的主要机制。尽管我们取得了很大的进步，但仍然有很多知识，该建议详细介绍了我们继续搜索以了解SWL可以继续为石材疾病提供安全有效治疗的物理机制。为了优化我们的科学进步，我们专注于将发现从实验室转变为制造商的一般方向。因此，在此提案中，我们寻求方法来改善SWL的设备和方法，并向制造商以及对此类改进的一般公众特定建议。为此，我们的具体目标总结如下：1）开发技术和设备，以提供监视反馈 空化，血流和石头洞察力对临床医生进行实时2）使用我们的双脉冲岩石纤维来检验我们的假设，即定位和加强空化场将最大程度地提高粉刺，同时最大程度地减少组织损伤； 3）确定岩石磨牙的冲击波还是空化簇塌陷产生的力是否产生石头内最大的应力； 4）测量冲击波波形的各个组件的个体效应，并从这些知识中设计出最佳的波形； 5）通过引入气泡内蒸发的效果，从这些研究中获得对SWL自由基生产水平的估计来扩展我们的空化模型能力。