ARFI and B-Mode Ultrasound Imaging for Transverse Carpal Ligament Pathomechanics

ARFI 和 B 型超声成像用于腕横韧带病理力学

• 批准号: 8700717
• 负责人: Zong-Ming Li
• 金额: $ 17.44万
• 依托单位: CLEVELAND CLINIC LERNER COM-CWRU
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-05-01 至 2016-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8700717
• 关键词: Accounting; Acoustics; Activities of Daily Living; Address; Biomechanics; Biomedical Engineering; Carpal Tunnel Syndrome; Clinical Research; Costs and Benefits; Data; Data Reporting; Development; Diagnosis; Disease; Elasticity; Emerging Technologies; Epidemiologic Studies; Etiology; Foundations; Future; General Population; Goals; Hand; Health Care Costs; Healthcare; Hypertrophy; Image; Imaging technology; Individual; Investigation; Knowledge; Ligaments; Literature; Measurement; Mechanics; Medical; Methods; Nerve compression syndrome; Occupational; Operative Surgical Procedures; Pathogenesis; Patients; Pilot Projects; Play; Population; Prevention; Prevention strategy; Productivity; Property; Public Health; Radiation; Research; Role; Severities; Speed; Technology; Testing; Thick; Tissues; Ultrasonography; United States; clinical application; cost; cost effective; high risk; improved; in vivo; innovation; insight; median nerve; novel; public health relevance; response; tool

DESCRIPTION (provided by applicant): Carpal tunnel syndrome (CTS) is the most common hand disorder, accounting for half a million carpal tunnel release surgeries annually in the United States. It has an immensely negative impact on national health care costs, worker productivity, and activities of daily living. Despite its impact on public health, our understandin of CTS etiology is limited. However, carpal tunnel pathomechanics is known to be an important contributor to the development of CTS. Notably, the transverse carpal ligament (TCL) plays a critical role in regulating carpal tunnel mechanics and is a potential factor in median nerve compression. The goal of this project is to explore a novel concept of the pathomorphological and pathomechanical properties of the TCL as an etiological factor of CTS. Our central hypothesis is that changes in the morphological and the mechanical properties of the TCL are pathogenic mechanisms of CTS. This hypothesis is supported by empirical observations during carpal tunnel release surgeries and preliminary data in the literature, yet it remains to be scientifically investigated. The specific aims of this project are (1) to examine the pathomorphology of the transverse carpal ligament associated with CTS using B-mode ultrasound imaging, and (2) to investigate the pathomechanics of the transverse carpal ligament associated with CTS using acoustic radiation force impulse (ARFI) ultrasound imaging. We will test the hypotheses that, in comparison to asymptomatic controls, the TCLs in CTS individuals are thicker and have a greater Young's modulus. This clinically oriented research innovatively applies ultrasound imaging technology for the identification of pathomorphological and pathomechanical markers of CTS. The results of this study will aid in the discovery of alternative pathogeneses of CTS. The noninvasive B-mode and ARFI imaging will provide convenient, cost-effective tools to screen high-risk CTS populations for prevention and to diagnose and assess the severity of CTS. In addition, critical new knowledge generated from this project will provide a foundation for a new research direction with profound occupational and clinical applications. Confirmation of our hypotheses will encourage a future large-scale clinical and epidemiological study that emphasizes carpal tunnel pathomorphology and pathomechanics as novel etiological factors of CTS. This pilot project, though developmental and exploratory, has a high benefit/cost ratio.

描述（由申请人提供）：腕管综合症（CTS）是最常见的手部疾病，在美国每年有 50 万例腕管松解手术。它对国家医疗保健费用、工人生产力和日常生活活动产生巨大的负面影响。尽管它对公共健康有影响，但我们对 CTS 病因的了解仍然有限。然而，腕管病理力学被认为是 CTS 发展的重要贡献者。值得注意的是，腕横韧带（TCL）在调节腕管力学方面发挥着关键作用，并且是正中神经受压的潜在因素。该项目的目标是探索 TCL 作为 CTS 病因的病理形态学和病理力学特性的新概念。我们的中心假设是 TCL 形态和机械特性的变化是 CTS 的致病机制。这一假设得到了腕管松解手术期间的经验观察和文献中的初步数据的支持，但仍有待科学调查。该项目的具体目标是 (1) 使用 B 型超声成像检查与 CTS 相关的腕横韧带的病理形态，以及 (2) 使用声辐射力脉冲 (ARFI) 超声成像研究与 CTS 相关的腕横韧带的病理力学。我们将测试以下假设：与无症状对照相比，CTS 个体的 TCL 更厚且杨氏模量更大。这项面向临床的研究创新性地应用超声成像技术来识别 CTS 的病理形态学和病理力学标志物。这项研究的结果将有助于发现 CTS 的替代发病机制。无创 B 型和 ARFI 成像将为筛查高危 CTS 人群进行预防以及诊断和评估 CTS 的严重程度提供方便、经济高效的工具。此外，该项目产生的关键新知识将为具有深刻职业和临床应用的新研究方向奠定基础。我们的假设的证实将鼓励未来的大规模临床和流行病学研究，强调腕管病理形态学和病理力学作为 CTS 的新病因。该试点项目虽然是开发性和探索性的，但具有较高的效益/成本比。