Leon-Carrion Jose, Dominguez-Roldan Jose Maria, Leon-Dominguez Umberto, Murillo-Cabezas Francisco
Human Neuropsychology Laboratory, Department of Experimental Psychology, University of Seville, Spain.
Brain Inj. 2010;24(10):1193-201. doi: 10.3109/02699052.2010.506636.
Early identification and treatment of intracranial haematomas in patients sustaining traumatic brain injury is fundamental to successful treatment. This pilot study evaluates the Infrascanner as a handheld medical screening tool for detection, in situ, of brain haematomas in patients with head injury.
This study included 35 TBI patients aged 17-76 (M = 47.6), admitted to the neurosurgical intensive care unit and observation unit of a University Hospital in a Level 1 trauma centre. The Infrascanner NIRS device uses near infrared light measurements to calculate optical density in brain regions.
Results show Infrascanner sensitivity at 89.5% and specificity at 81.2%. PPV was 85% and NPV 86.7%. The device detected 90% of extra-axial, 88.9% of intra-axial and 93.3% of non-surgical haematomas (less than 25 mL). PPV for this classification was 82.3%; 87.5% sensitivity was found when the Infrascanner exam was performed within 12 hours post-trauma, whereas after 12 hours post-trauma, exams had 90.1% sensitivity.
This study demonstrates that the Infrascanner is useful in initial examinations and screenings of patients with head injury as an adjunct to a CT scan or when it is not available and may allow earlier treatment and reduce secondary injury caused by present and delayed haematomas.
对于创伤性脑损伤患者，早期识别并治疗颅内血肿是成功治疗的关键。本初步研究评估了Infrascanner作为一种手持式医疗筛查工具，用于原位检测头部受伤患者脑内血肿的情况。
本研究纳入了35名年龄在17 - 76岁（平均年龄47.6岁）的创伤性脑损伤患者，这些患者被收治于一级创伤中心的一家大学医院的神经外科重症监护病房和观察病房。Infrascanner近红外光谱设备利用近红外光测量来计算脑区的光密度。
结果显示Infrascanner的灵敏度为89.5%，特异度为81.2%。阳性预测值为85%，阴性预测值为86.7%。该设备检测出90%的轴外血肿、88.9% 的轴内血肿以及93.3% 的非手术性血肿（小于25毫升）。此分类的阳性预测值为82.3%；在创伤后12小时内进行Infrascanner检查时，灵敏度为87.5%，而在创伤后12小时后进行检查时，灵敏度为90.1%。
本研究表明，Infrascanner作为CT扫描的辅助手段，或在无法进行CT扫描时，对于头部受伤患者的初步检查和筛查很有用，可能有助于更早地进行治疗，并减少现有血肿和延迟性血肿导致的继发性损伤。
