New Photo-Acoustic Imaging Process in Fetal Monitoring to Dramatically Reduce Brain Injuries in Newborns

项目总结 摘要 布里姆罗斯技术公司和约翰霍普金斯大学正在组建一个强大的新团队，以使 一种新的工具有可能极大地减少一个主要的全球健康问题-围产期缺氧- 缺血性脑病(HIE)--通过在分娩过程中及早发现。缺氧缺血性脑病是由窒息引起的 婴儿死亡的原因以及脑性瘫痪和其他长期严重神经疾病的根源 减损。医学界对HIE的早期诊断一直受到限制，因为目前的胎儿心脏 心率监测的特异性较差。如果及早发现，HIE可以通过治疗得到有效治疗。 体温过低。我们提出了一种胎儿光声监测系统，可以测量氧合血红蛋白。 分娩时矢状窦静脉饱和引流胎儿大脑皮层。矢状窦氧合血红蛋白 当胎盘气体交换受损(缺氧)和/或胎儿时，饱和度降低到非常低的水平 脑灌流压下降(缺血)。光声仪器通过开口处传输光 Fontanelle或骨骼，并进入大脑静脉和组织，在那里产生超声波。使用近乎- 不连续波长的红外入射光优先被氧合和脱氧血红蛋白吸收， 在胎儿头皮上检测到的每个波长的超声波都可以估计氧合血红蛋白的饱和度。布里姆罗斯 已经构建了一种新的超声波检测技术，其灵敏度超过数量级 目前使用最好的压电式传感器。这将允许使用低功率LED光源，而不是 现在使用笨重的激光灯，从而避免使用安全护目镜，并促进更大的 部署。霍普金斯大学的研究小组已经验证了标准光声系统 通过新生仔猪头骨准确估计矢状窦血氧饱和度。目的 第一阶段的目的是演示使用安全、低功率LED光源的可行性 超灵敏超声传感器检测极低的矢状窦血氧饱和度 氧合作用是被操纵的。该平台将基于硅内模拟，以优化声学和 头骨和大脑的光学路径。以秒为时间尺度的实时测量将通知 宫缩期间脑氧合动态波动的产科照顾者。第二阶段的目标是 制作一个微型光声设备原型，可以报告胎儿大脑的氧合情况。我们相信 由此产生的仪器将以更高的特异性和敏感度提供早期检测大脑HI，使早期能够 干预和治疗，并有可能转移到商业模式的生产。

PROJECT SUMMARY Summary The Brimrose Technology Corporation and Johns Hopkins University are forming a powerful new team to make a new instrument that has the potential to dramatically reduce a major global health problem–perinatal hypoxic- ischemic encephalopathy (HIE)–by enabling early detection during labor. HIE caused by asphyxia is a leading cause of infant fatalities as well as a source of cerebral palsy and other long-term severe neurologic impairments. The medical community has been limited in early diagnosis of HIE because current fetal heart rate monitoring has poor specificity. If identified early, HIE can be treated effectively with therapeutic hypothermia. We are proposing a fetal photoacoustic monitoring system that measures oxyhemoglobin saturation of the sagittal sinus vein draining the fetal cerebral cortex during labor. Sagittal sinus oxyhemoglobin saturation decreases to very low levels when placental gas exchange is impaired (hypoxia) and/or when fetal cerebral perfusion pressure falls (ischemia). The photoacoustic instrument transmits light through the open fontanelle or bone and into cerebral veins and tissue where ultrasound waves are generated. Using near- infrared incident light at discrete wavelengths that are absorbed preferentially by oxy- and deoxy-hemoglobin, ultrasound detected on the fetal scalp at each wavelength can estimate oxyhemoglobin saturation. Brimrose has constructed a novel ultrasound detection technology with sensitivity orders of magnitude greater than the current best-use piezo-electric sensors. This will permit the use of low-power LED light sources rather than cumbersome laser lights now employed, thereby avoiding safety goggle use and promoting greater deployment. The Hopkins team has already validated the ability of a standard photoacoustic system to accurately estimate sagittal sinus oxyhemoglobin saturation through the skull of newborn piglets. The purpose of Phase I is to demonstrate the feasibility of using safe, low power LED light sources with the new ultrasensitive ultrasound sensor to detect critically low sagittal sinus oxyhemoglobin saturation when oxygenation is manipulated. The platform will be based on in-silico simulation to optimize the acoustic and optical pathways for the skull and brain. Real-time measurements on a time scale of seconds will inform the obstetric caregiver of dynamic fluctuations of brain oxygenation during contractions. The Phase II goal is to make a miniaturized photoacoustic device prototype that can report on fetal brain oxygenation. We believe the resulting instrument will provide early detection brain HI with greater specificity and sensitivity, enabling early intervention and treatment and is potentially transferrable to a commercial model for manufacture.