Development of Novel Methods for Tissue Characterization in the Heart with Ultrasound Imaging

背景：超声成像是最广泛使用的医学成像方式之一（全世界有成千上万的临床和研究机器），因为它相对较低的成本，安全性（无电离辐射X射线），便携性和快速采集速度。 心脏病的超声成像（超声心动图）通常用于测量心脏结构和功能，血流和心脏的其他几个特性（最常用的临床成像测试用于诊断心脏病）。然而，超声心动图（应用于心脏的超声）目前不用于检测心脏中的瘢痕（纤维化）。 * * 当心肌受损（例如心脏病发作）时，部分肌肉死亡并形成保护性疤痕，称为替代性纤维化，由胶原蛋白等结构分子组成。 心脏病的准确诊断和最佳治疗处方需要有关心脏瘢痕（纤维化）形成的信息。 目前，磁共振成像（MRI）是检测纤维化的金标准测试。然而，MRI相对昂贵，在主要医院中心之外不可用，排除了许多患者（例如，许多植入器械的患者、重症监护环境中的患者、肥胖患者），并且需要注射造影剂以检测纤维化。 拟议的计划将集中在超声成像的发展，使疤痕（纤维化）的成像。方法：我们将使用一种特殊的超声成像模式（称为谐波超声）来实现我们的目标。 谐波声波是由具有某些材料特性的结构产生的。 心脏病形成的疤痕组织主要由胶原蛋白和其他分子组成，这些分子能产生非常强的谐波声波。 通过优化超声成像以提供来自胶原蛋白的最大谐波信号，我们期望能够生成心脏中疤痕组织的清晰图像。 ** 影响：新的心脏疤痕超声心动图测试的发展将立即影响超声成像领域以及成千上万的加拿大人。 我们希望我们提出的技术创新将推进心脏和所有其他组织的超声成像领域。 对于加拿大人来说，我们预计加拿大最常见的心脏病（心脏病发作）的更快，更便宜和更广泛的测试将导致医疗保健的改善。 最好的治疗（基于准确的诊断）在初始事件发生后尽快应用将产生最大的影响。 通过为心脏病学中最广泛使用的成像工具（超声心动图）提供疤痕成像，我们希望每天使用超声波改善大型医疗中心和较小卫星中心的一线医疗护理。

Development of Novel Methods for Tissue Characterization in the Heart with Ultrasound Imaging******BACKGROUND: Ultrasound imaging is one of the most widely used medical imaging modalities (tens of thousands of clinical and research machines worldwide) as a result of its relatively low cost, safety (no ionizing radiation X-Rays), portability and rapid acquisition speeds. Ultrasound imaging in heart disease (Echocardiography) is routinely used to measure heart structure and function, blood flow, and several other properties of the heart (most used clinical imaging test for diagnosis of heart disease). However, Echocardiography (ultrasound applied to the heart) is not currently used to detect scar (fibrosis) in heart. ******MOTIVATION: When the heart muscle is damaged (e.g. heart attack), part of the muscle dies and a protective scar forms, called replacement fibrosis, which is composed of structural molecules such as collagen. The accurate diagnoses of heart disease and optimal prescription of therapy requires information about the formation of scar (fibrosis) in the heart. Currently, magnetic resonance imaging (MRI) is the gold standard test for the detection of fibrosis. However, MRI is relatively expensive, not available outside major hospital centres, excludes many patients (e.g. many with implanted devices, those in critical care environments, obese patients) and requires an injected contrast agent injection to detect fibrosis. The proposed program will center on the development of ultrasound imaging to allow the imaging of scar (fibrosis).******METHODS: We will achieve our goals using a special mode of ultrasound imaging called harmonic ultrasound. Harmonic sound waves are generated from structures that have certain material properties. The scar tissue that forms in heart disease is made primarily of collagen and other molecules that generate very strong harmonic sound waves. By optimizing ultrasound imaging to give the maximum harmonic signal from collagen, we expect to be able to generate clear images of scar tissue in the heart. ******IMPACT: The development of new echocardiography tests for scar in the heart will immediately impact the field of ultrasound imaging as well as thousands of Canadians. We expect our proposed technical innovations will advance the field of ultrasound imaging, in the heart and all other tissues. For Canadians, we anticipate that a faster, cheaper and more widely available test for the most common heart disease in Canada (heart attack) will lead to improved delivery of health care. The best therapy (based on accurate diagnosis) applied as soon as possible after the initial event will have the highest impact. By providing imaging of scar to the most widely available imaging tool in cardiology (Echocardiography) we hope to improve frontline medical care in both large medical centres and the smaller satellite centres using ultrasound on a daily basis.