Real time and noninvasive monitoring of blood flow during surgery

描述（由申请人提供）：外科医生进行复杂的血管手术，如动脉瘤夹闭，如果能获得手术野血流的即时信息，他们将受益。目前的高分辨率血流监测技术要么使用复杂的专用设备，要么依赖于造影剂的使用，这两种技术都对外科手术有破坏性，因此是不可取的。我们提出了一种新的方法，可以无创地在微血管的空间尺度上提供外科医生视野内血流的实时实时信息。这种模块化光学成像系统（称为surgontm）将与手术室现有的外科显微镜集成，以适度的成本负担增加关键的血流监测能力。这种互补的血流信息将使用专有和许可的激光散斑对比成像技术获得，并选择性地在他/她的视野覆盖在感兴趣的区域上呈现给外科医生。我们的第一阶段工作包括设计外科医生系统，实时获取高分辨率的血流信息，并测试其在手术阻断大脑中动脉的替代动物模型中术中使用的可行性。具体来说，外科医生系统将利用一种新的方法，在现场可编程门阵列（FPGA）上高速处理激光散斑数据，减少实时信息可用的延迟，同时优化空间和时间分辨率的折衷。如果成功，我们预计将开展二期项目，在此期间，我们将开发临床级外科医生系统，并研究其在神经外科临床中的性能和效用。由于大脑背景下高分辨率血流信息的关键性质，第一和第二阶段的工作重点是神经外科，外科医生系统将通过将标准手术显微镜转换为先进的血流测量显微镜，在所有手术中发挥潜在的推动作用。

DESCRIPTION (provided by applicant): Surgeons performing complex vascular surgeries as aneurysm clipping could benefit if instantaneous information on blood flow in their surgical field was made available to them. Current technologies that can monitor blood flow at high resolution either engage complex dedicated equipment or rely on administration of contrast agents, both of which are disruptive to the surgical procedure and hence, undesired. We propose a novel method that can noninvasively provide real time live information about blood flow in the surgeon's field of view at the spatial scale of microvessels. This modular optical imaging system (called the SurgeONTM) will integrate with existing surgical microscopes in operating rooms to add the crucial blood flow monitoring capability at a modest cost burden. This complementary blood flow information will be obtained using proprietary and licensed laser speckle contrast imaging technology, and optionally presented to the surgeon in his/her visual field overlaid on the region of interest. Our Phase I effort comprises of engineering the SurgeON system to obtain high resolution blood flow information in real-time and testing the feasibility of its intraoperative use in a surrogate animal model during the surgical occlusion of the middle cerebral artery. Specifically, the SurgeON system will utilize a novel method of high speed processing of laser speckle data on a field programmable gate array (FPGA) reducing the latency with which real time information may be available while optimizing the compromise in spatial and temporal resolution. If successful, we anticipate undertaking a Phase II project, during which we will develop a clinical grade SurgeON system and investigate its performance and utility in the clinic during neurosurgery. While the focus of the Phase I and II efforts is on neurosurgery due to crucial nature of high-resolution blood flow information in the context of the brain, the SurgeON system will potentially play an enabling role in all surgeries by converting a standard surgical microscope to an advanced blood flow measuring microscope.