Quantifying Cervical Softness with Elasticity Imaging

通过弹性成像量化宫颈柔软度

• 批准号: 7991724
• 负责人: Helen Feltovich
• 金额: $ 20.47万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-25 至 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7991724
• 关键词: Acoustics; Behavior; Biochemistry; Biomechanics; Catheters; Cervical; Cervix Uteri; Clinic; Collaborations; Collagen; Communication; Development; Discipline of obstetrics; Elasticity; Evaluation; FDA approved; Fetus; Foundations; Functional disorder; Generations; Goals; Heart; Human; Hysterectomy; Image; Investigation; Judgment; Lead; Measurement; Measures; Mechanics; Membrane; Methods; Microscopy; Molecular Biology; Monitor; Morbidity - disease rate; Noise; Outcome; Patients; Physiologic pulse; Pregnancy; Premature Birth; Process; Progesterone; Prostaglandins; Provider; Radiation; Reproducibility; Research Design; Risk; Scanning; Signal Transduction; Specimen; Standardization; Structure; Techniques; Technology; Testing; Therapeutic; Time; Tissues; Transducers; Ultrasonography; Uterine cavity; Work; base; clinical decision-making; clinical practice; human subject; improved; in vivo; innovation; insight; novel; novel therapeutics; public health relevance; quantitative ultrasound; second harmonic; simulation; technology development; tool

DESCRIPTION (provided by applicant): The objective of this proposal is to develop a quantitative ultrasound technique (acoustic radiation force impulse) to noninvasively and objectively assess cervical stiffness/softness. A key benefit of our work is that development of a method to measure cervical stiffness/softness alone could have significant impact; cervical softness is a critical, yet subjective, measure made daily in an obstetrics clinic. Our goal is to use such a tool to build a comprehensive understanding of cervical microstructure and how it changes throughout normal and abnormal pregnancy. We anticipate that an enhanced understanding of cervical microstructural changes will lead to targeted investigation of specific remodeling processes in pregnancy that will promote understanding of cervical insufficiency. This in turn could guide the exploration of novel therapeutic strategies. PUBLIC HEALTH RELEVANCE: This is a proposal to develop quantitative ultrasound technology using acoustic radiation force impulse (ARFI) tools in ex vivo hysterectomy specimens in order to ultimately image and objectively quantify in vivo cervical softening in pregnancy. Cervical softening occurs throughout normal pregnancy but morbidity may occur when the cervix is too soft too early (preterm delivery) or too firm too late (postterm delivery). Currently, we have only subjective assessment of this important parameter. That alone makes objective quantification of cervical softening clinically useful. Even more, cervical softening is related to cervical microstructural arrangement and thus strength. The proposed effort involves (a) determining the sensitivity of ultrasound to the changes in stiffness/softness of the human cervix, (b) testing ARFI in isotropic and anisotropic phantoms as well as ex vivo cervical tissue in order to establish parameters for transition to in vivo cervical scanning, and (c) confirming through second harmonic generation microscopy the cervical microstructural changes that are associated with our ultrasound measurements. Besides providing an objective measure of a clinically useful parameter, development of a tool to quantify cervical softening should also give insight into cervical structure and function, including the dysfunction that leads to preterm delivery.

描述（由申请人提供）：本提案旨在开发一种定量超声技术（声辐射力脉冲），以无创和客观地评估颈椎硬度/柔软度。我们工作的一个关键好处是，开发一种单独测量颈椎刚度/柔软度的方法可能会产生重大影响;颈椎柔软度是产科诊所每天进行的一项重要但主观的测量。我们的目标是使用这样一个工具来建立一个全面的了解宫颈显微结构，以及它如何在整个正常和异常妊娠的变化。我们预计，对宫颈微结构变化的深入了解将导致对妊娠期特定重塑过程的有针对性的调查，这将促进对宫颈功能不全的了解。这反过来又可以指导新的治疗策略的探索。 公共卫生相关性：这是一项在体外子宫切除标本中使用声辐射力脉冲（ARFI）工具开发定量超声技术的建议，以便最终成像并客观量化妊娠期体内宫颈软化。子宫颈软化发生在整个正常妊娠，但发病率可能发生在子宫颈太软过早（早产）或太硬过晚（过期分娩）。目前，我们对这一重要参数只有主观评估。仅这一点就使得客观量化宫颈软化在临床上有用。更重要的是，宫颈软化与宫颈微结构排列有关，从而与强度有关。拟议的努力涉及（a）确定超声对人类宫颈刚度/柔软度变化的敏感性，（B）在各向同性和各向异性体模以及离体宫颈组织中测试ARFI，以建立过渡到体内宫颈扫描的参数，以及（c）通过二次谐波发生显微镜确认与我们的超声测量相关的宫颈微结构变化。除了提供临床有用参数的客观测量外，开发量化宫颈软化的工具还应深入了解宫颈结构和功能，包括导致早产的功能障碍。