Ultrasound Guidance and Display

超声波是最常见的医学图像，最近超过了x射线。即时护理是超声领域增长最快的领域，尤其是麻醉学领域。这种增长是由超声的几个趋势驱动的：小型化、成本降低和通用硬件上先进的数字图像处理。一个典型的使用案例是用超声波瞄准周围神经，然后将针引导到目标并注射麻醉。限制进一步发展的问题是图像质量仍然经常不足，并且护理点操作员是新手/未经超声培训。操作人员仍然在努力进行手眼协调，以便根据床边监视器上经常有噪声的图像引导针头到达患者体内的目标。我们需要的是在图像质量和特定临床应用的易用性方面取得重大飞跃。这样的飞跃不仅有利于医疗点的应用，而且从长远来看，最终可以向社区办公室的初级保健医生打开超声波市场。初级保健医生占所有医生的三分之一，占所有办公室就诊的51%，但由于这些问题，没有广泛使用超声波。该基金将开发改善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。***提高成像速度，然后在形成最终图像之前捕获更多信息，从而解决更好的2D图像质量问题。以前，提高速度会损害空间细节或深度穿透。我们建议利用电信的最新进展，即数字编码，来开发新的快速超声成像技术，而不会妥协。作为第一个应用，我们将专门致力于提高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。***更好的3D图像质量将通过使用快速成像在感兴趣的区域快速扫描超声换能器以捕获3D全景来解决，而不会模糊或遇到无意的患者运动。***将通过改进向医生展示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，除了患者床边的常规监视器。这将包括目标位置的描述，在超声中识别，以及适当的针头轨迹。***所有这些技术都可以单独或一起在商用超声机上实施，从加拿大制造的超声波开始。这些技术将使几种麻醉程序比目前的“盲”注射更容易和更准确，这应该转化为更好和更容易获得麻醉。针头放错位置导致的并发症减少也将降低医院费用

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.**