High-frequency ultrasound imaging can provide exquisite visualizations of tissue to guide minimally invasive procedures.Here,we demonstrate that an all-optical ultrasound transducer,through which light guided by optic...High-frequency ultrasound imaging can provide exquisite visualizations of tissue to guide minimally invasive procedures.Here,we demonstrate that an all-optical ultrasound transducer,through which light guided by optical fibers is used to generate and receive ultrasound,is suitable for real-time invasive medical imaging in vivo.Broad-bandwidth ultrasound generation was achieved through the photoacoustic excitation of a multiwalled carbon nanotube-polydimethylsiloxane composite coating on the distal end of a 300-μm multi-mode optical fiber by a pulsed laser.The interrogation of a high-finesse Fabry–Pérot cavity on a single-mode optical fiber by a wavelength-tunable continuous-wave laser was applied for ultrasound reception.This transducer was integrated within a custom inner transseptal needle(diameter 1.08 mm;length 78 cm)that included a metallic septum to acoustically isolate the two optical fibers.The use of this needle within the beating heart of a pig provided unprecedented realtime views(50 Hz scan rate)of cardiac tissue(depth:2.5 cm;axial resolution:64μm)and revealed the critical anatomical structures required to safely perform a transseptal crossing:the right and left atrial walls,the right atrial appendage,and the limbus fossae ovalis.This new paradigm will allow ultrasound imaging to be integrated into a broad range of minimally invasive devices in different clinical contexts.展开更多
立体脑电图(SEEG)是一种将电极植入大脑以帮助确定致痫灶的操作。它是在非侵入性检查不能确定致痫灶的情况下,对耐药性局灶性癫痫患者进行明确的癫痫手术之前进行的。这项操作的主要风险是出血,发生率为1%～2%,可能原因是电极放置不准确...立体脑电图(SEEG)是一种将电极植入大脑以帮助确定致痫灶的操作。它是在非侵入性检查不能确定致痫灶的情况下,对耐药性局灶性癫痫患者进行明确的癫痫手术之前进行的。这项操作的主要风险是出血,发生率为1%～2%,可能原因是电极放置不准确,或者计划的植入电极损伤了在术前血管成像中未检测到的血管。推荐的电极植入技术包括:使用立体定向框架、无框架影像导航系统、机器人导航系统和定制的患者固定装置。研究参照系统评价和Meta分析推荐报告条目(Preferred reporting items for systematic reviews and Metaanalysis,PRISMA),结构化搜索Pub Med、Embase和Cochrane数据库,纳入的研究涉及:(1)SEEG电极植入作为术前工作的一部分;(2)针对耐药性局灶性癫痫患者;(3)提供准确数据。数据库检索出326篇文章,删除重复和非英语语言的研究后,筛选出293篇文章。应用纳入和排除标准后,最终有15项研究纳入定性和定量分析。利用随机效应的元分析和技术分层,最终总结出SEEG电极植入的准确性。发表有关SEEG植入技术的准确性文献有限。目前并没有比较不同SEEG植入技术的前瞻性对照临床试验。在已确定的研究之间存在显著的系统异质性,妨碍了各项技术之间有意义的比较。最近引进的机器人导航系统被认为提供了一种更精确的植入方法,但支持证据仅限于3级。在将新技术引入进行广泛临床应用之前,有必要通过良好设计、方法合理的研究将新技术与以前的"金标准"进行比较。展开更多
基金the European Research Council(ERC-2012-StG,Proposal 310970 MOPHIM)an Innovative Engineering for Health award from the Wellcome Trust(WT101957)+4 种基金Engineering and Physical Sciences Research Council(EPSRC)(NS/A000027/1)the EPSRC and European Union project FAMOS(FP7 ICT,Contract 317744)by National Institute for Health Research University College London Hospitals Biomedical Research Centrethe National Institute for Health Research Bartsthe London Biomedical Research Unit.
文摘High-frequency ultrasound imaging can provide exquisite visualizations of tissue to guide minimally invasive procedures.Here,we demonstrate that an all-optical ultrasound transducer,through which light guided by optical fibers is used to generate and receive ultrasound,is suitable for real-time invasive medical imaging in vivo.Broad-bandwidth ultrasound generation was achieved through the photoacoustic excitation of a multiwalled carbon nanotube-polydimethylsiloxane composite coating on the distal end of a 300-μm multi-mode optical fiber by a pulsed laser.The interrogation of a high-finesse Fabry–Pérot cavity on a single-mode optical fiber by a wavelength-tunable continuous-wave laser was applied for ultrasound reception.This transducer was integrated within a custom inner transseptal needle(diameter 1.08 mm;length 78 cm)that included a metallic septum to acoustically isolate the two optical fibers.The use of this needle within the beating heart of a pig provided unprecedented realtime views(50 Hz scan rate)of cardiac tissue(depth:2.5 cm;axial resolution:64μm)and revealed the critical anatomical structures required to safely perform a transseptal crossing:the right and left atrial walls,the right atrial appendage,and the limbus fossae ovalis.This new paradigm will allow ultrasound imaging to be integrated into a broad range of minimally invasive devices in different clinical contexts.
文摘立体脑电图(SEEG)是一种将电极植入大脑以帮助确定致痫灶的操作。它是在非侵入性检查不能确定致痫灶的情况下,对耐药性局灶性癫痫患者进行明确的癫痫手术之前进行的。这项操作的主要风险是出血,发生率为1%～2%,可能原因是电极放置不准确,或者计划的植入电极损伤了在术前血管成像中未检测到的血管。推荐的电极植入技术包括:使用立体定向框架、无框架影像导航系统、机器人导航系统和定制的患者固定装置。研究参照系统评价和Meta分析推荐报告条目(Preferred reporting items for systematic reviews and Metaanalysis,PRISMA),结构化搜索Pub Med、Embase和Cochrane数据库,纳入的研究涉及:(1)SEEG电极植入作为术前工作的一部分;(2)针对耐药性局灶性癫痫患者;(3)提供准确数据。数据库检索出326篇文章,删除重复和非英语语言的研究后,筛选出293篇文章。应用纳入和排除标准后,最终有15项研究纳入定性和定量分析。利用随机效应的元分析和技术分层,最终总结出SEEG电极植入的准确性。发表有关SEEG植入技术的准确性文献有限。目前并没有比较不同SEEG植入技术的前瞻性对照临床试验。在已确定的研究之间存在显著的系统异质性,妨碍了各项技术之间有意义的比较。最近引进的机器人导航系统被认为提供了一种更精确的植入方法,但支持证据仅限于3级。在将新技术引入进行广泛临床应用之前,有必要通过良好设计、方法合理的研究将新技术与以前的"金标准"进行比较。
