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

项目摘要 总结 Brimrose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， 一种新的工具，有可能大大减少一个主要的全球健康问题-围产期缺氧- 缺血性脑病（HIE）-通过在分娩过程中早期发现。新生儿缺氧缺血性脑病是新生儿缺氧缺血性脑病的主要病因之一， 是婴儿死亡的原因，也是脑瘫和其他长期严重神经系统疾病的来源 损伤由于目前的胎心监护技术， 速率监测的特异性差。如果早期发现，HIE可以有效地治疗， 体温过低我们提出了一个胎儿光声监测系统，测量氧合血红蛋白 分娩时引流胎儿大脑皮质的矢状窦静脉饱和。鼻窦氧合血红蛋白 当胎盘气体交换受损（缺氧）和/或胎儿缺氧时， 脑灌注压福尔斯下降（缺血）。光声仪器通过开口传输光 并且进入产生超声波的脑静脉和组织。使用near- 优选被氧合血红蛋白和脱氧血红蛋白吸收的离散波长的红外入射光， 在胎儿头皮上检测到的每个波长的超声波可以估计氧合血红蛋白饱和度。布里姆罗斯 已经构建了一种新颖的超声检测技术，其灵敏度的数量级大于 目前最好用的压电传感器。这将允许使用低功率LED光源，而不是 现在采用笨重的激光灯，从而避免了安全护目镜的使用， 部署.霍普金斯团队已经验证了标准光声系统的能力， 通过新生仔猪的颅骨准确估计矢状窦氧合血红蛋白饱和度。目的 的第一阶段是证明使用安全的可行性，低功耗LED光源与新的 超灵敏超声传感器，用于检测严重低的矢状窦血氧饱和度， 控制氧合。该平台将基于计算机模拟，以优化声学和 头骨和大脑的光学通路以秒为时间尺度的实时测量将通知 产科护理人员在收缩期间脑氧合的动态波动。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 由此产生的仪器将提供具有更高特异性和灵敏度的早期检测脑HI， 并可能转移到用于制造商业模型。

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.