Semenova Zh B, Marshintsev A V, Melnikov A V, Meshcheryakov S V, Adayev A R, Lukyanov V I
a Research Institute of Emergency Pediatric Surgery and Trauma , Health Department , Moscow , Russia.
Brain Inj. 2016;30(1):18-22. doi: 10.3109/02699052.2014.989401. Epub 2015 Dec 14.
The number of traumatic injuries among children is increasing. However, so-called mild TBI might result in unfavourable outcomes. Early diagnosis of intracranial haematomas prior to development of serious complications may be a decisive factor for a favourable outcome. InfraScan company developed and brought to the market the Infrascanner model 1000, which is a portable detector of blood collections that operates in the near infrared (NIR) band.
To estimate the efficiency of the Infrascanner model 1000 for detection of intracranial haematomas among children with mild TBI.
Ninety-five patients with mild TBI were examined. An indication for cerebral CT after mild TBI was the presence of risk factors of intracranial lesions. The Infrascanner was used by a neurosurgeon during primary examination. CT was performed in 43 patients (45%), while 52 patients (55%) with a low risk of intracranial lesions were under observation.
The results of examination of patients using CT and infrared scanning coincided in 39 cases and intracranial haematomas were detected in eight patients. False-positive results were obtained in three cases. The sensitivity of the procedure used in this group of patients with a medium and high risk of development of intracranial haemorrhages was 1.00 (0.66; 1.00). The specificity was 0.91 (0.81; 1.00)--the proportions and a 95% CI. The false-positive risk is 0.27 (0.00; 0.58). During infrared scanning in patients with low risk of intracranial lesions, false-positive results were obtained in four cases and false-negative results were absent.
Infra-scanning might be viewed as a screening technique for intracranial haemorrhages in ambulances and outpatient trauma centres in order to decide on hospitalization, CT scanning and referral to a neurosurgeon. Infra-scanning combined with evaluation of risk factors of intracranial damage might reduce the number of unnecessary radiological examinations.
儿童创伤性损伤的数量正在增加。然而,所谓的轻度创伤性脑损伤(TBI)可能会导致不良后果。在严重并发症发生之前早期诊断颅内血肿可能是取得良好预后的决定性因素。InfraScan公司研发并将Infrascanner 1000型号推向市场,它是一种在近红外(NIR)波段运行的便携式血液聚集探测器。
评估Infrascanner 1000型号在检测轻度TBI儿童颅内血肿方面的效率。
对95例轻度TBI患者进行了检查。轻度TBI后进行脑部CT检查的指征是存在颅内病变的危险因素。神经外科医生在初次检查时使用了Infrascanner。43例患者(45%)进行了CT检查,而52例颅内病变风险较低的患者(55%)接受观察。
使用CT和红外扫描检查患者的结果在39例中一致,8例患者检测出颅内血肿。3例出现假阳性结果。在这组颅内出血发生风险为中高的患者中,所采用程序的敏感性为1.00(0.66;1.00)。特异性为0.91(0.81;1.00)——比例及95%置信区间。假阳性风险为0.27(0.00;0.58)。在颅内病变风险较低的患者进行红外扫描时,4例出现假阳性结果,未出现假阴性结果。
红外扫描可被视为救护车和门诊创伤中心用于颅内出血的筛查技术,以便决定住院治疗、CT扫描以及转诊给神经外科医生。红外扫描结合颅内损伤危险因素评估可能会减少不必要的放射学检查数量。