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儿童门静脉高压症的形状

2026年9月29日 更新者:Thomas Jefferson University

儿童门脉高压症的无创次谐波辅助压力估计

Early diagnosis of portal hypertension is difficult as symptoms rarely manifest until the later stages of liver disease. Both cirrhotic and non-cirrhotic portal hypertension can result in life-threatening complications, the most frequent of which is bleeding from esophageal varices. In children, variceal bleeds are associated with mortality rates of 1-3 %, while life-threatening complications have been reported in up to 20 % of children with cirrhosis. Despite the high incidence of portal hypertension in children with liver disease, a noninvasive modality to monitor disease progression and risk of complications is currently lacking. Hence, this trial will investigate the safety and efficacy of subharmonic aided pressure estimation (SHAPE) as a noninvasive ultrasound technique for diagnosing portal hypertension in children.

研究概览

研究类型

介入性

注册 (实际的)

12

阶段

  • 阶段2

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习地点

    • Pennsylvania
      • Philadelphia、Pennsylvania、美国、19104
        • The Children's Hospital of Philadelphia

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

6年 至 21年 (孩子、成人)

接受健康志愿者

不

有资格学习的性别

全部

描述

Inclusion Criteria:

  • Patients with a diagnosis of chronic liver disease without portal hypertension.
  • Patients with a diagnosis of chronic liver disease with portal hypertension.

Exclusion Criteria:

  • Subjects who are pregnant.
  • Patients with known or suspected hypersensitivity to egg phosphatidyl serine or with a history of anaphylactic allergy to eggs or egg products.
  • Subjects with allergy to egg products or other components of the ultrasound contrast agents will be excluded.
  • History of allergic reaction to Lumason®, sulfur hexafluoride, sulfur hexafluoride lipid microsphere components, or other ingredients in Lumason (polyethylene glycol, distearoylphosphatidylcholine (DSPC), dipalmitoylphosphatidylglycerol sodium (DPPG-Na), palmitic acid)
  • History of allergic reaction to Sonazoid
  • Patients with biliary atresia with asplenia or polysplenia.
  • Patients with prior liver transplant.
  • Patients with cystic fibrosis.
  • Patients with chronic lung disease.
  • Patients with portal vein thrombosis, cavernous transformation of the portal vein or absent portal vein.
  • Adults not competent/impaired.
  • Patients with significant heart disease or severe congenital heart disease

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

  • 主要用途:诊断
  • 分配:随机化
  • 介入模型:并行分配
  • 屏蔽:无(打开标签)

武器和干预

参与者组/臂
干预/治疗
实验性的:SHAPE with Sonazoid

Up to 60 children (6-21 years of age) with a diagnosis of chronic liver disease, including some who will have portal hypertension who are followed at The Children's Hospital of Philadelphia (CHOP) will be enrolled in this arm. A SHAPE measurement using the ultrasound contrast agent Sonazoid® (perfluorobutane microbubbles) will be performed during a single visit. A dose of three vials with 16 μL each of microbubbles will be prepared. An infusion of the ultrasound contrast agent at the rate of 0.18 mL/kg/hour will be co-infused with an infusion of saline at the rate of 120 mL/hour resulting in an effective dosage of 1.44 μL microbubbles/kg/hour as per the FDA approved IND through an IV line in a peripheral vein. The total duration of contrast agent infusion is expected to range from 4 to 8 minutes, which includes a 2 min calibration period followed by 2-6 minutes of SHAPE acquisition (i.e., ultrasound imaging).

The ultrasound contrast agent will be infused thorough an IV line and SHAPE ultrasound imaging and data acquisition will be performed with a Logiq E10 (GE Medical Systems, Waukesha, WI) ultrasound scanner.

有源比较器:SHAPE with Lumason

Up to 60 children (6-21 years of age) with a diagnosis of chronic liver disease, including some who will have portal hypertension who are followed at CHOP will be enrolled in this arm. A SHAPE measurement using the ultrasound contrast agent LUMASON® (sulfur hexafluoride lipid-type A microspheres) will be performed during a single visit. Two doses of 0.03 mL/kg (or 2.4 mL maximum) as per package labeling will be prepared and mixed with saline at a 1:10 dilution in a 50 ml bag of saline. The diluted preparation of Lumason will be through an IV line in a peripheral vein up to 4 mL/min using an infusion setup. The total duration of contrast agent infusion is expected to range from 4 to 8 minutes, which includes a 2 min calibration period followed by 2-6 minutes of SHAPE acquisition (i.e., ultrasound imaging).

The ultrasound contrast agent will be infused thorough an IV line and SHAPE ultrasound imaging and data acquisition will be performed with a Logiq E10 (GE Medical Systems, Waukesha, WI) ultrasound scanner.

实验性的:Longitudinal SHAPE

SHAPE will be used to monitor subjects identified in the initial examination as having portal hypertension for up to 18 months. These subjects will undergo laboratory testing every 6 months as a part of their clinical standard of care. During these times the SHAPE examination will also be repeated using the same ultrasound contrast agent and infusion methodologies (including dosages) as during the initial study.

The ultrasound contrast agent will be infused thorough an IV line and SHAPE ultrasound imaging and data acquisition will be performed with a Logiq E10 (GE Medical Systems, Waukesha, WI) ultrasound scanner.

The ultrasound contrast agent will be infused thorough an IV line and SHAPE ultrasound imaging and data acquisition will be performed with a Logiq E10 (GE Medical Systems, Waukesha, WI) ultrasound scanner.

研究衡量的是什么?

主要结果指标

结果测量
大体时间
Sonazoid 的不良事件发生率 (%) 与儿科 Lumason 包装说明书中报告的当前不良事件发生率 (0.001%) 相比
大体时间:2小时
2小时
门静脉和肝静脉之间校准的次谐波微泡信号(以 dB 为单位)将区分门脉高压和非门脉高压组,准确度为 94%
大体时间:2小时
2小时

次要结果测量

结果测量
大体时间
门静脉和肝静脉之间校准的次谐波微泡信号(以 dB 为单位)随时间的变化将预测门脉高压并发症(静脉曲张出血、腹水、肝肺综合征等)的发展
大体时间:平均18个月
平均18个月
门静脉和肝静脉之间的校准次谐波微泡信号(以 dB 为单位)和肝纤维化阶段(根据肝活检确定的 0-4 等级)将与 p<0.05 相关
大体时间:2小时
2小时
比较分别用 Lumason 和 Sonazoid 获得的门静脉和肝静脉之间校准的次谐波微泡信号(以 dB 为单位),以了解它们区分门脉高压和非门脉高压组的能力
大体时间:2小时
2小时
使用回归分析将门静脉和肝静脉之间的校准次谐波微泡信号(以 dB 为单位)与剪切波弹性成像值(以 m/s 为单位)进行比较
大体时间:2小时
2小时

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

调查人员

  • 首席研究员:Sudha A Anupindi, MD、Children's Hospital of Philadelphia
  • 首席研究员:Flemming Forsberg, PhD、Thomas Jefferson University

出版物和有用的链接

负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2021年11月3日

初级完成 (实际的)

2025年8月31日

研究完成 (实际的)

2026年9月8日

研究注册日期

首次提交

2021年1月4日

首先提交符合 QC 标准的

2021年1月19日

首次发布 (实际的)

2021年1月22日

研究记录更新

最后更新发布 (实际的)

2026年10月2日

上次提交的符合 QC 标准的更新

2026年9月29日

最后验证

2026年9月1日

更多信息

与本研究相关的术语

其他相关的 MeSH 术语

其他研究编号

  • 20F.728
  • R01DK118964 (美国 NIH 拨款/合同)

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)?

是的

IPD 计划说明

Data generated from the proposed study will be shared to make the results available to the scientific community.

Presentations at national scientific meetings.

Lectures.

Post-graduate training.

Approximately 12 months after the completion of the trial (when the main manuscript has been published) individual researchers can contact the PIs and request the final, complete data-set from this trial without any protected health information

IPD 共享时间框架

Approximately 12 months after the completion of the trial when the main manuscript has been published

IPD 共享访问标准

On an individual basis - contact the PIs

IPD 共享支持信息类型

  • 研究方案
  • 树液
  • 国际碳纤维联合会

药物和器械信息、研究文件

研究美国 FDA 监管的药品

是的

研究美国 FDA 监管的设备产品

不

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