论文标题
颈静脉静脉压力变化期间颈静脉动力学的光学血流动力学成像
Optical Hemodynamic Imaging of Jugular Venous Dynamics During Altered Central Venous Pressure
论文作者
论文摘要
提出了一种光学成像系统，用于定量评估颈静脉反应对中央静脉压力改变的反应。提出的系统评估了通过空间校准程序从颈静脉波形中进行的地下光学吸收变化，以使入射组织照明正常化。使用新型的柔性表面校准方法捕获并校准右侧颈部的宽场框架。得出了血液动力学模型来量化颈静脉光学衰减（JVA）信号，并生成空间颈静脉脉动图。在三种心血管方案中评估了JVA，这些方案改变了中央静脉压力：急性中枢性低血容量（下半身负压），静脉充血（头向倾斜）和心脏填充受损（Valsalva操纵）。当与心电图对齐时，JVA波形表现出与颈静脉脉冲动力学一致的双相波性能。 JVA在级分中心低血症（r = 0.85，[0.72，0.95]）期间与浸润性中心静脉压力强（[0.72，0.95]），分级静脉充血（r = 0.94，[0.84，0.99]），与浸润性的中心静脉压力相关联（r = 0.85，0.99]），与侵入性的中心静脉压力相关联（[0.84，0.99]），并且心脏填充（r = 0.94，[0.94，[0.85，0.94，[0.85，0.99）]。从基线（sv：79 $ \ pm $ 15 ml，jva：0.56 $ \ pm $ 0.10 a.u. $ p pm pmmmhg suction（sv：79 $ \ pm $ p p pm p pm p p pm p p p p pmmhg suction），降低的JVA与中风体积（SV）（r = 0.85，[0.76，0.92]）密切相关（r = 0.85，[0.76，0.92]）（r = 0.85，[0.76，0.92]） 0.47 $ \ pm $ 0.05 a.u。p $ <$ 0.01）。提出的非接触式光学成像系统表明，在改变中央静脉压力的三个方案中，与侵入性中央静脉监测一致的颈静脉动力学。该系统在传统上需要导管插入术的临床相关条件下，对压力诱导的颈静脉动力学进行了无创的监测，从而在非手术环境中进行监测。
An optical imaging system is proposed for quantitatively assessing jugular venous response to altered central venous pressure. The proposed system assesses sub-surface optical absorption changes from jugular venous waveforms with a spatial calibration procedure to normalize incident tissue illumination. Widefield frames of the right lateral neck were captured and calibrated using a novel flexible surface calibration method. A hemodynamic optical model was derived to quantify jugular venous optical attenuation (JVA) signals, and generate a spatial jugular venous pulsatility map. JVA was assessed in three cardiovascular protocols that altered central venous pressure: acute central hypovolemia (lower body negative pressure), venous congestion (head-down tilt), and impaired cardiac filling (Valsalva maneuver). JVA waveforms exhibited biphasic wave properties consistent with jugular venous pulse dynamics when time-aligned with an electrocardiogram. JVA correlated strongly (median, interquartile range) with invasive central venous pressure during graded central hypovolemia (r=0.85, [0.72, 0.95]), graded venous congestion (r=0.94, [0.84, 0.99]), and impaired cardiac filling (r=0.94, [0.85, 0.99]). Reduced JVA during graded acute hypovolemia was strongly correlated with reductions in stroke volume (SV) (r=0.85, [0.76, 0.92]) from baseline (SV: 79$\pm$15 mL, JVA: 0.56$\pm$0.10 a.u.) to -40 mmHg suction (SV: 59$\pm$18 mL, JVA: 0.47$\pm$0.05 a.u.; p$<$0.01). The proposed non-contact optical imaging system demonstrated jugular venous dynamics consistent with invasive central venous monitoring during three protocols that altered central venous pressure. This system provides non-invasive monitoring of pressure-induced jugular venous dynamics in clinically relevant conditions where catheterization is traditionally required, enabling monitoring in non-surgical environments.
