Development of Intraoperative Ultrasonic 3D Imaging System for Assessment of Graft Anastomosis in Coronary Artery Bypass Grafting

2018 Fiscal Year Final Research Report

• Project/Area Number: 15K10208
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Cardiovascular surgery
• Research Institution: Tokyo Medical and Dental University
• Principal Investigator: ARAI Hirokuni 東京医科歯科大学, 大学院医歯学総合研究科, 教授 (50202718)
• Research Collaborator: OISHI Kiyotoshi ; OHUCHI Katsuhiro ; MIZUNO Tomohiro ; FUJIWARA Tatsuki
• Project Period (FY): 2015-04-01 – 2019-03-31
• Keywords: 冠動脈外科学 / 冠動脈バイパス術 / 手術支援システム / 高周波心外膜エコー / 三次元画像構築

Outline of Final Research Achievements

We developed novel 3D imaging system which enables real-time visualization of graft anastomotic morphology during CABG procedure. This system consists of a high-frequency epicardial ultrasound (ECUS) equipment and an electromagnetic position-tracking sensor.
Following in vitro assessment of graft anastomosis using vessel phantom and extracted porcine heart model, in vitro assessment using living pig heart model was performed. 2D echo images obtained by ECUS and 3D position sensor information were simultaneously transferred to the 3D analyzing system. By integrating geo-tagged 2D ECUS images, 3D images could be reconstructed in real time. The obtained 3D images enabled morphological assessment of luminal structure of coronary anastomosis from any required angle or cross section, with satisfactory quality. With further improvement of precision of positional sensor, this system would be clinically applicable as useful tool for intraoperative graft evaluation in CABG.

Free Research Field

心臓血管外科

Academic Significance and Societal Importance of the Research Achievements

学術的意義：画像・空間情報を統合する外科手術支援システムの開発は既に多くの成果が挙げられているが、冠動脈バイパス術中評価に特化し高い解像度・分解能を持つ高周波心外膜エコー装置に応用した例は他に見当たらない。高い解像度・分解能が必要な領域での超音波画像のリアルタイム3D化技術は、低侵襲手術など術者の視覚情報が制限される高難度手術領域で今後の応用が期待されている。
社会的意義：冠動脈バイパス術中にリアルタイムで吻合部3D構造を提示することは、現状の血管造影検査やトランジットタイム血流計による血流計測等より高品質な吻合部評価が可能となり、周術期・遠隔期の臨床成績の向上に直結する。