Simultaneous fetal echocardiography and magnetocardiography

同时胎儿超声心动图和心磁图

• 批准号: 7571676
• 负责人: DOUGLAS N PAULSON
• 金额: $ 28.41万
• 依托单位: TRISTAN TECHNOLOGIES, INC.
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-26 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7571676
• 关键词: Address; Adoption; Adult; Area; Arrhythmia; Cardiac; Clinical; Clinical Research; Complex; Congenital Heart Defects; Data; Detection; Development; Devices; Disease; Doppler Echocardiography; Early identification; Echocardiography; Economic Development; Ensure; Equipment Design; Fetal Death; Fetal Heart; Fetus; Frequencies; Functional disorder; Goals; Head; Heart; Heart Diseases; Heart failure; Image; Ischemia; Knowledge; Laboratories; Lead; Life; Link; Magnetometries; Measurement; Mechanics; Methods; Patients; Pattern; Personal Satisfaction; Phase; Positioning Attribute; Pregnancy; Qualifying; Radial; Risk; Risk Factors; Rotation; Series; Signal Transduction; Surface; System; Tail; Techniques; Technology; Time; Tissues; Transducers; Ultrasonic Transducer; Ultrasonics; Ultrasonography; Wisconsin; base; computerized data processing; congenital heart disorder; design; design and construction; fetal; fetus at risk; hemodynamics; in utero; instrument; programs; sensor; superconducting quantum interference device; symposium; vector

DESCRIPTION (provided by applicant): Electrophysiological and mechanical interactions in the fetus are largely unstudied. There is an established need to enhance the current echocardiography/Doppler capabilities of recognizing the fetus at risk of life threatening cardiac complications. Direct simultaneous comparison of fetal magnetocardiography using Superconducting Quantum Interference Device (SQUID) magnetometry and Doppler will allow, for the first time, assessment of electromechanical disturbances associated with heart failure and severe arrhythmia. This instrument will directly address the fetal cardiac disorders that effect about 1-3% of all pregnancies. This proposal aims to develop an fMCG vector gradiometer instrument specifically designed for combined use with echocardiography for the characterization of the intrauterine clinical condition of fetuses with life- threatening arrhythmias, acquired heart failure, and structural congenital heart disease. The system will have in addition a very small tail and radial gap so the echo probe can be positioned very closely over the same area. Compared to existing conventional one-component magnetometers, the instrument will be inexpensive, lightweight and easily producible. The system can be either a stand-alone or an add-on to existing MEG rooms. Neither of the existing MEG or MCG systems are designed for these types of measurements. In addition the system will make the use of at least one type of Echocardiac transducer reliable when positioned 2 cm from the base of the system. This probe will be capable of being rigid adjacent to the system or adjustable in rotation and tilt remotely as desired. Several key technical issues were identified, which will be addressed in Phase II. Vector coils are needed to ensure that the (arbitrarily positioned) fetal heart can be detected with reasonable signal strength. There is a need to stabilize the transducer, while permitting the required degree of maneuverability for ultrasound imaging. Third is the need to reduce the size of the fMCG sensor array in order to provide greater access to the maternal surface for echo/Doppler imaging. Fourth is the development of optimal signal processing techniques for the new sensor configuration, particularly for reduction of non-stationary low frequency interference. And fifth is the need to better study the relationship between the echo/Doppler transducer positioning (angle and orientation) and the sensor array positioning, in order to facilitate the recording of additional or more traditional Doppler planes while not compromising, and perhaps even facilitating the quality of the fMCG signal. The findings on Phase I generated enough knowledge to develop, and assured the need of a suitable instrument capable of simultaneous ultrasound/fMCG recordings. The successful completion of this program has the potential to lead to a significant ability to identify fetal arrhythmias. In addition, this product should enhance assessment of fetal well-being by identifying risk factors for sudden fetal death, including cardiac ischemia, QT prolongation, and electromechanical dysfunction. This proposal aims to develop better methods of characterizing the intrauterine clinical condition of fetuses with life-threatening arrhythmias, acquired heart failure, and structural congenital heart disease by the development of an economical, noninvasive simultaneous fetal echocardiography and magnetocardiography system. Direct simultaneous comparison of fetal magnetocardiographic (fMCG) recordings in conjunction with Echocardiography and Doppler (echo/Doppler), will enhance current echo/Doppler capabilities of recognizing the fetus at risk of life-threatening cardiac complications. We are developing the first instrument specially designed for these dual measurements.

描述（由申请人提供）：胎儿的电生理和机械相互作用在很大程度上尚未研究。有一个既定的需要，以提高目前的超声心动图/多普勒识别胎儿的生命危险的心脏并发症的能力。使用超导量子干涉仪（SQUID）磁力测量和多普勒直接同步比较胎儿心磁图将首次允许评估与心力衰竭和严重心律失常相关的机电干扰。该仪器将直接解决影响约1-3%的所有妊娠的胎儿心脏疾病。该提案旨在开发一种专门设计用于与超声心动图联合使用的fMCG矢量梯度仪仪器，用于表征患有危及生命的心律失常、获得性心力衰竭和结构性先天性心脏病的胎儿的宫内临床状况。此外，该系统将具有非常小的尾部和径向间隙，因此回波探头可以非常接近地定位在同一区域上。与现有的传统单分量磁力计相比，该仪器将是廉价的，重量轻，易于生产。该系统可以是独立的，也可以是现有MEG室的附加设备。现有的MEG或MCG系统都不是为这些类型的测量而设计的。此外，当定位在距离系统底座2 cm处时，系统将使用至少一种类型的超声心动图传感器。该探头将能够在系统附近是刚性的，或者根据需要远程调节旋转和倾斜。确定了若干关键技术问题，将在第二阶段加以解决。需要矢量线圈来确保可以以合理的信号强度检测到（任意定位的）胎儿心脏。需要稳定换能器，同时允许超声成像所需程度的可操作性。第三是需要减小fMCG传感器阵列的尺寸，以便提供对母体表面的更大访问以进行回波/多普勒成像。第四是为新的传感器配置开发最佳信号处理技术，特别是减少非平稳低频干扰。第五，需要更好地研究回波/多普勒换能器定位（角度和方向）与传感器阵列定位之间的关系，以便于记录额外的或更传统的多普勒平面，同时不损害，甚至可能促进fMCG信号的质量。第一阶段的研究结果产生了足够的知识来开发，并确保需要一种能够同时进行超声/fMCG记录的合适仪器。该项目的成功完成有可能导致识别胎儿心律失常的显著能力。此外，该产品应通过识别胎儿猝死的风险因素（包括心脏缺血、QT间期延长和机电功能障碍）来加强对胎儿健康的评估。 该提案旨在通过开发一种经济、无创的同时胎儿超声心动图和心磁图系统，开发更好的方法来表征胎儿宫内临床状况，包括危及生命的心律失常、获得性心力衰竭和结构性先天性心脏病。直接同步比较胎儿心磁图（fMCG）记录与超声心动图和多普勒（回波/多普勒），将增强当前回波/多普勒识别胎儿有危及生命的心脏并发症风险的能力。我们正在开发第一台专门为这些双重测量而设计的仪器。