Ultrasound Guidance and Display

超声波是最常见的医学图像，最近超过了X射线。医疗点是超声领域增长最快的领域，尤其是麻醉学。这一增长是由超声的几个趋势推动的：小型化、成本降低和在通用硬件上进行先进的数字图像处理。一个典型的用例是用超声波瞄准周围神经，然后将针引导到这个目标上，并注射麻醉剂。限制进一步增长的问题是，图像质量仍然经常不够充分，而且护理点操作员是新手/没有接受过超声波培训。根据床边监视器上经常有噪音的图像，操作员仍然在努力实现将针引导到患者体内目标所需的手眼协调。需要的是图像质量和易用性方面的重大飞跃，以满足特定的临床应用。这样的飞跃不仅将使医疗保健应用程序受益，而且从长远来看，可能最终会向社区办公室的初级保健医生开放超声波市场。初级保健医生占所有医生的三分之一，就诊人数占所有就诊人数的51%，但由于这些问题，他们并没有广泛使用超声波。这笔赠款将开发提高2D和3D图像质量的方法，并通过将关键信息直接投射到患者身上来提高易用性。*通过提高成像速度，然后在形成最终图像之前捕获更多信息，将解决更好的2D图像质量问题。以前，增加速度会影响空间细节或深度穿透。我们建议利用电信领域的最新进展，即数字编码，在不妥协的情况下开发新的快速超声成像技术。作为第一批应用，我们将特别致力于改善骨表面和神经的图像质量，因为它们是麻醉学中许多程序的关键。*通过使用快速成像技术在感兴趣的区域快速扫描超声换能器以捕捉3D全景，而不会模糊或遇到意外的患者运动，将解决更好的3D图像质量问题。*将通过改进向医生呈现解剖和指导信息的方式来解决更好的易用性问题。我们将开发一种简单、低成本的增强现实显示器，直接在患者感兴趣的区域上显示，除了患者床边通常的监视器。这将包括超声识别的目标位置的描述，以及适当的针头轨迹。*所有这些技术都可以单独实施，也可以在商业超声机上一起实施，首先是加拿大制造的超声波。这些技术将使几种麻醉程序比目前的“盲目”注射更容易、更准确，这应该会转化为更好、更多地获得麻醉。减少针头错位引起的并发症也将降低医院成本。**

Ultrasound is the most common medical image, recently surpassing x-rays. Point-of-care is the fastest growing sector in ultrasound, especially anesthesiology. This growth is driven by several trends in ultrasound: miniaturization, cost-reduction, and advanced digital image processing on generic hardware. A typical use-case is to target a peripheral nerve with ultrasound, then guide a needle to that target and inject anesthesia. The problems limiting further growth are that the image quality is still often inadequate, and the point-of-care operators are novices/untrained in ultrasound. Operators still struggle with the hand-eye coordination needed to guide a needle to the target in the patient based on an often-noisy image on a bedside monitor. What is needed is a significant leap in image quality and ease-of-use for specific clinical applications. Such a leap would not only benefit point-of-care applications, but in the long term could finally open the ultrasound market to primary care physicians in neighbourhood offices. Primary care physicians comprise one third of all physicians and see 51% of all office visits, but do not widely use ultrasound due to these problems. This grant will develop methods to improve image quality in both 2D and 3D, and improve ease-of-use by projecting key information directly on the patient.***Better 2D image quality will be addressed by improving the imaging speed and then capturing more information before forming a final image. Previously, increasing speed compromised spatial detail or depth penetration. We propose to leverage recent advances in telecommunications, namely digital codes, to develop new fast ultrasound imaging techniques without this compromise. As the first applications, we will aim specifically to improve the image quality of bone surfaces and nerves because they are key for many procedures in anesthesiology. ***Better 3D image quality will be addressed by using fast imaging to quickly sweep the ultrasound transducer over a region of interest to capture a 3D panorama, without blurring or encountering inadvertent patient motion.***Better ease-of-use will be addressed by improving the way the anatomical and guidance information is presented to the physician. We will develop a simple, low cost, augmented reality display directly over the region of interest on the patient, in addition to the usual monitor at the patient bedside. This will include the depictions of the target location, identified in ultrasound, and appropriate needle trajectory. ***All of these techniques can be implemented individually or together on commercial ultrasound machines starting with the Canadian-made Ultrasonix. These techniques will make several anesthesia procedures easier and more accurate than current "blind" injections, which should translate into better and greater access to anesthesia. Fewer complications from misplaced needles will also reduce hospital costs.**