Assessment of cerebrospinal fluid flow

 描述（由申请人提供）：脑室内脑脊液（CSF）过度积聚（脑积水）是一种经常严重损害中枢神经系统组织的疾病，如果不治疗可能导致死亡。儿童的估计患病率为1/500，颅内压过高会显著损害智力发育，如果发生在婴儿期，通常会导致颅骨膨出。自20世纪60年代初以来，脑室腹膜（VP）分流术一直是标准治疗方法，并显著提高了小儿脑积水患者的生存率和生活质量。尽管取得了这些进展，但故障和翻修手术仍很常见。儿童VP分流器的故障率估计在放置后第一年为40%，之后每年为10%。目前用于诊断分流器故障的方法通常是侵入性的，需要电离辐射，或者对患者来说是昂贵的。该项目的总体目标是开发一种安全，成本效益高的方法，利用超声诊断分流故障。我们提出了一种基于对比度增强实时超声成像和使用2D互相关技术的同步运动估计的分流导管中的CSF流量评估方法。与目前的临床成像协议相比，我们的方法是微创的，具有成本效益，并且可以在医生的办公室进行检查，最终节省了患者的时间和金钱。当前提案的目的是开发和确定这种新的诊断成像技术的可行性，并通过体模、组织和动物研究验证方法。该项目的直接预期成果将是准备进行临床前和初步临床测试的设备和相关软件。

 DESCRIPTION (provided by applicant): Excessive buildup of cerebrospinal fluid (CSF) within the brain's ventricular system (hydrocephalus) is a disease that often seriously damages tissues in the central nervous system and may result in death if left untreated. The estimated prevalence in children is 1 in 500, with the excess intracranial pressure significantly impairing mental development, and often causing cranial bulging if occurring in infancy. Ventriculoperitoneal (VP) shunts have been the standard treatment since the early 1960s and have increased the survival rate and quality of life of pediatric hydrocephalus patients significantly. Despite these gains, malfunction and revision surgery are common occurrences. The rate of malfunction of VP shunts in children is estimated to be 40% in the first year after placement, and 10% per year after that. Current methods for diagnosing shunt malfunctions are often invasive, require ionizing radiation, or are expensive for the patient. The overall goal of te project is to develop a safe, cost-effective method for diagnosing shunt malfunctions using ultrasound. We propose a method for CSF flow assessment in a shunt catheter based on contrast-enhanced real-time ultrasound imaging and simultaneous motion estimation using a 2D cross correlation technique. Compared to current clinical imaging protocols, our approach is minimally invasive, cost-effective, and the examination can be performed in a doctor's office, ultimately saving the patient time and money. The objective of the current proposal is to develop and establish the feasibility of this new diagnostic imaging technique and to validate the methodology with phantom, tissue and animal studies. The immediate expected outcome of this project will be a device and associated software ready for preclinical and preliminary clinical testing.