Wearable Electrostrictive Row-Column Ultrasound Arrays for Longitudinal Echocardiography

用于纵向超声心动图的可穿戴电致伸缩行列超声阵列

• 批准号: 10354880
• 负责人: Roger J Zemp
• 金额: $ 16.2万
• 依托单位: UNIVERSITY OF ALBERTA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-18 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10354880
• 关键词: 3-Dimensional; 3D ultrasound; Acoustics; Address; Adhesives; Algorithms; Ambulatory Monitoring; Area Under Curve; Arrhythmia; Arterial Lines; Atrial Fibrillation; Back; Beds; Biochemical; Blood Pressure; Cardiac Output; Cardiogenic Shock; Cardiovascular system; Catheters; Clinical; Coupling; Data; Deposition; Development; Diagnosis; Disadvantaged; Discipline; Doppler Ultrasound; EFRAC; Echocardiography; Electrodes; Electronics; Elements; Environment; Evaluation; Excision; Family suidae; Gel; Gold; Hand; Heart; Histopathology; Human; Hypotension; Image; Imagery; Intensive Care; Intensive Care Units; Label; Left; Lesion; Lung; Manuals; Measurement; Measures; Medicine; Metabolism; Methodology; Methods; Microscopy; Modality; Monitor; Nature; Operative Surgical Procedures; Outpatients; Patient imaging; Patients; Pattern; Pharmaceutical Preparations; Physiologic pulse; Polychlorinated Biphenyls; Positioning Attribute; Pulmonary Hypertension; Pulmonary artery structure; Pump; Regimen; Research; Resolution; Risk; Scanning; Scheme; Shock; Side; Skin; Specimen; Speed; Surgical Oncology; System; Techniques; Technology; Testing; Thermodilution; Three-Dimensional Imaging; Time; Time trend; Tissues; Transducers; Tricuspid Valve Insufficiency; Ultrasonography; Venous; base; breast lumpectomy; cardiovascular imaging; design; diagnostic platform; electric impedance; first-in-human; heart function; heart imaging; hemodynamics; human imaging; hypoperfusion; imaging capabilities; imaging modality; improved; minimally invasive; non-invasive monitor; novel; point of care; pressure; programs; pulmonary arterial pressure; remote sensing; serial imaging; ultrasound; ultraviolet; vascular injury; voltage

Project Summary / Abstract In patients admitted to intensive care units (ICUs) with shock (low blood pressure) that results in both clinical and biochemical evidence of tissue hypoperfusion due to inadequate cardiac output, clinicians commonly seek to assess and monitor cardiac function, but all available invasive and non-invasive methodologies have significant limitations and/or risk. The gold standard method to assess cardiac output and shock states is a pulmonary arterial catheter (PAC) which is inserted through a venous canula and passes through the right side of the heart into the pulmonary artery. The advantages of this modality are that it provides information on right and left heart pressures, and allows for the calculation of cardiac output via thermodilution techniques. Its disadvantages include the invasive nature resulting the potential risk of vascular injury. Moreover, cardiac outputs are inaccurate in common cardiac arrhythmias (ex atrial fibrillation) and valvular lesions (ex tricuspid regurgitation), and only provides information on overall cardiac function without direct information on left and right heart function. Non-invasive cardiac output monitors (NICOMs) use proprietary bio-impedance or arterial line area under the curve algorithms to estimate cardiac output. While these are minimally invasive, they have not been well validated in patients in cardiogenic shock and provide no information on left and right heart function. Finally, point of care ultrasound (POCUS) allows echocardiographic evaluation of left and right heart function, but it is not well suited for evaluation of continuous or temporal trends in cardiac function given it requires a clinician to acquire images at the bedside. A wearable ultrasound probe that would enable hands-free longitudinal imaging of patients would prove to be of considerable value in the ICU environment. In this proposal we introduce a radically new wearable ultrasound technology, bias-sensitive electrostrictive top- orthogonal-to-bottom electrode (TOBE) arrays. These TOBE arrays offer readout from every element of a 2D array through biasing control and transmit-receive control of only rows and columns, rather than require wiring from every element. With novel readout approaches, these arrays will be demonstrated to achieve image quality comparable to a linear array, but with full electronic 3D scanning capabilities. Unlike MATRIX probes that rely on complicated micro-beamformers, our approach is simpler, yet allows for advanced imaging modes such as ultrafast imaging at thousands of frames per second. We propose the development of such ultrafast imaging modes with wearable TOBE probes for angle-agnostic flow estimation and longitudinal electronic tracking of right and left heart function. The angle-agnostic flow estimation avoids errors due to unknown Doppler angles and mitigates the need for manual probe positioning. In this proposal, we aim to further develop the transducer technology, interfacing electronics, and imaging methods to enable angle-agnostic flow imaging in phantoms, then with first-in-human imaging. We aim to establish feasibility data for future research into advanced longitudinal monitoring of cardiac output, ejection fractions, pulmonary artery pressure, etc.

项目总结/摘要 在因休克（低血压）进入重症监护室（ICU）的患者中， 由于心输出量不足而导致的组织灌注不足的生物化学证据，临床医生通常寻求 评估和监测心脏功能，但所有可用的侵入性和非侵入性方法， 重大限制和/或风险。评估心输出量和休克状态的金标准方法是 肺动脉导管（PAC），通过静脉套管插入并穿过右侧 进入肺动脉这种方式的优点是它提供了正确的信息 和左心压力，并允许通过热稀释技术计算心输出量。其 缺点包括导致血管损伤的潜在风险的侵入性。此外，心脏 常见心律失常（房颤除外）和瓣膜病变（三尖瓣除外）的输出不准确 反流），并且仅提供关于总体心脏功能的信息，而没有关于左和 右心功能无创心输出量监测仪（NICOM）使用专有的生物阻抗或动脉阻抗测量技术， 曲线下的线面积算法来估计心输出量。虽然这些都是微创的，但它们 在心源性休克患者中没有得到很好的验证，也没有提供关于左右心功能的信息。 最后，床旁超声（POCUS）允许超声心动图评价左和右心功能， 但它不太适合于评价心脏功能的连续或暂时趋势，因为它需要 临床医生在床边采集图像。一种可穿戴的超声波探头， 患者的纵向成像将证明在ICU环境中具有相当大的价值。 在这项提案中，我们介绍了一种全新的可穿戴超声技术，偏置敏感电致伸缩顶部， 正交底电极（TOBE）阵列。这些TOBE阵列提供从2D的每个元件的读出， 阵列通过偏置控制和收发控制只对行和列进行，而不需要布线 从每一个元素。通过新的读出方法，这些阵列将被证明可以实现图像质量 与线性阵列相当，但具有完整的电子3D扫描功能。不像MATRIX探测器， 在复杂的微型波束形成器上，我们的方法更简单，但允许高级成像模式， 每秒数千帧的超快成像。我们建议发展这种超快成像技术 可穿戴式TOBE探头模式，用于角度不可知的流量估计和右侧纵向电子跟踪 和左心功能与角度无关的流量估计避免了由于未知多普勒角度引起的误差， 减少了对手动探针定位的需要。在这个提议中，我们的目标是进一步开发传感器 技术、接口电子设备和成像方法，以实现体模中的角度不可知的流动成像， 然后进行首次人体成像。我们的目标是为未来的先进研究建立可行性数据 心输出量、射血分数、肺动脉压等的纵向监测。