Measurement of Renal Viscoelastic Properties with Ultrasound

超声测量肾粘弹特性

• 批准号: 8661764
• 负责人: Matthew William Urban
• 金额: $ 43.14万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-07 至 2017-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8661764
• 关键词: Adult; American; Biopsy; Chronic Kidney Failure; Clinical; Clinical Management; Computer software; Coronary artery; Coupled; Creatinine; Data; Diagnosis; Disease; Elasticity; End stage renal failure; Focused Ultrasound Therapy; Frequencies; Geometry; Glomerular Filtration Rate; Goals; Gold; Graft Rejection; Graft Survival; Health; Hemodialysis; Histocompatibility Testing; Human; Image; Kidney; Kidney Diseases; Kidney Failure; Kidney Transplantation; Knowledge; Life; Liver; Measurement; Measures; Medical; Medical Imaging; Methods; Modality; Modeling; Modification; Monitor; Nature; Pathology; Patient Monitoring; Patients; Physicians; Procedures; Process; Property; Prostate; Radiation; Renal function; Research; Research Proposals; Serum; Skeletal Muscle; Speed; Structure; Survival Rate; System; Techniques; Therapeutic Intervention; Tissues; Transducers; Translations; Transplantation; Treatment Protocols; Ultrasonography; Validation; Viscosity; Visit; aged; base; diagnosis standard; follow-up; healthy volunteer; human subject; imaging modality; improved; in vivo; insight; outcome forecast; programs; screening; simulation; soft tissue; tool; viscoelasticity

DESCRIPTION (provided by applicant): Background: Chronic kidney disease (CKD) encompasses a long-term decrease in function of the kidneys which afflicts 11.5% in American adults aged 20 and over, which is more than 20 million people. CKD can progress to kidney failure or end-stage renal disease (ESRD). At the end of 2008, 547,982 patients were receiving ESRD therapy, which includes hemodialysis or kidney transplant. Patient and renal graft survival rates have increased over the past five decades, but long-term survival of grafts is still an issue. Renal biopsy is the gold standard for diagnosis of kidney health, but is an invasive procedure, can not be used frequently, and can cause complications. Noninvasive indicators of kidney disease including levels of serum creatinine, glomerular filtration rate, and classical medical imaging can provide certain insights into kidney disease state. Elasticity imaging methods are emerging as a way to discriminate healthy versus diseased tissue based on the elasticity or viscosity of the tissue. When the structure of tissue changes due to disease processes, the function and viscoelastic properties also change. We propose the use of a quantitative, noninvasive method called shearwave dispersion ultrasound vibrometry (SDUV) to measure these quantities for assessment of renal health. Method: SDUV uses focused ultrasound to "push" the tissue and create shear waves. Ultrasound-based methods are used to detect the propagation of the shear waves through the tissue. The propagation speed of the shear waves varies with frequency, a phenomenon known as dispersion. This shear wave speed dispersion can be used to evaluate the shear elasticity and viscosity of the tissue. Studies in many different types of tissue including liver, kidney, skeletal muscle, prostate, heart and arteries have shown that SDUV can be a useful method for quantitatively evaluating the viscoelastic properties of tissue. SDUV measurements are noninvasive, fast, and localized to a small region of tissue. This noninvasive measurement technique can be suitable as a first-line screening tool to reduce the numbers of biopsies. Additionally, it can be used as a quantitative indicator for frequent assessment and monitoring of patients undergoing treatment regimens to track progress. SDUV techniques developed in this project could be implemented on modern ultrasound scanners with software modifications for widespread clinical translation. Aims: 1. Develop analytic methods and optimize implementation of SDUV for viscoelastic characterization of the native and transplanted human kidney. 2. Study the relationships between SDUV measurements of the viscoelastic properties of native kidneys of healthy kidney donors and patients with chronic kidney disease. 3. Study the relationship between SDUV measurements of viscoelastic material properties with clinical measures for assessment of kidney transplant rejection.

描述（由申请人提供）： 背景：慢性肾脏病 (CKD) 包括肾脏功能的长期下降，在 20 岁及以上的美国成年人中，有 11.5% 的人患有这种疾病，这一数字超过 2000 万人。 CKD 可进展为肾衰竭或终末期肾病 (ESRD)。截至2008年底，547,982名患者正在接受ESRD治疗，其中包括血液透析或肾移植。在过去的五年中，患者和肾移植物的存活率有所提高，但移植物的长期存活率仍然存在问题 一个问题。肾活检是诊断肾脏健康状况的金标准，但它是一种侵入性检查，不能经常使用，并且可能引起并发症。肾脏疾病的无创指标，包括血清肌酐水平、肾小球滤过率和经典医学影像，可以提供对肾脏疾病状态的某些了解。弹性成像方法正在成为一种根据组织的弹性或粘度区分健康组织和患病组织的方法。当组织结构因疾病过程而发生变化时，其功能和粘弹性也会发生变化。我们建议使用一种称为剪切波色散超声振动测量 (SDUV) 的定量、非侵入性方法来测量这些量，以评估肾脏健康状况。方法：SDUV 使用聚焦超声波“推动”组织并产生剪切波。基于超声波的方法用于检测剪切波通过组织的传播。剪切波的传播速度随频率而变化，这种现象称为色散。这种剪切波速度分散可用于评估组织的剪切弹性和粘度。对许多不同类型的组织（包括肝脏、肾脏、骨骼肌、前列腺、心脏和动脉）的研究表明，SDUV 可以成为定量评估组织粘弹性特性的有用方法。 SDUV 测量是无创的、快速的并且局限于组织的一个小区域。这种无创测量技术适合作为一线筛查工具，以减少活检数量。此外，它还可以用作定量指标，用于对接受治疗方案的患者进行频繁评估和监测，以跟踪进展情况。该项目开发的 SDUV 技术可以在现代超声扫描仪上实施，并修改软件以进行广泛的临床转化。目标： 1. 开发分析方法并优化 SDUV 的实施，以对天然和移植的人肾进行粘弹性表征。 2. 研究健康肾脏捐赠者和慢性肾脏病患者的自体肾脏粘弹性特性的 SDUV 测量之间的关系。 3. 研究粘弹性材料特性的 SDUV 测量与肾移植排斥反应评估的临床测量之间的关系。