Ljungqvist Johan, Candefjord Stefan, Persson Mikael, Jönsson Lars, Skoglund Thomas, Elam Mikael
1 Department of Neurosurgery, Sahlgrenska University Hospital , Gothenburg, Sweden .
2 Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, The Sahlgrenska Academy at the University of Gothenburg , Gothenburg, Sweden .
J Neurotrauma. 2017 Jul 1;34(13):2176-2182. doi: 10.1089/neu.2016.4869. Epub 2017 Mar 13.
Traumatic brain injury (TBI) is the leading cause of death and disability among young persons. A key to improve outcome for patients with TBI is to reduce the time from injury to definitive care by achieving high triage accuracy. Microwave technology (MWT) allows for a portable device to be used in the pre-hospital setting for detection of intracranial hematomas at the scene of injury, thereby enhancing early triage and allowing for more adequate early care. MWT has previously been evaluated for medical applications including the ability to differentiate between hemorrhagic and ischemic stroke. The purpose of this study was to test whether MWT in conjunction with a diagnostic mathematical algorithm could be used as a medical screening tool to differentiate patients with traumatic intracranial hematomas, chronic subdural hematomas (cSDH), from a healthy control (HC) group. Twenty patients with cSDH and 20 HC were measured with a MWT device. The accuracy of the diagnostic algorithm was assessed using a leave-one-out analysis. At 100% sensitivity, the specificity was 75%-i.e., all hematomas were detected at the cost of 25% false positives (patients who would be overtriaged). Considering the need for methods to identify patients with intracranial hematomas in the pre-hospital setting, MWT shows promise as a tool to improve triage accuracy. Further studies are under way to evaluate MWT in patients with other intracranial hemorrhages.
创伤性脑损伤(TBI)是年轻人死亡和残疾的主要原因。改善TBI患者预后的关键是通过实现高分类准确性来减少从受伤到确定性治疗的时间。微波技术(MWT)允许在院前环境中使用便携式设备在受伤现场检测颅内血肿,从而加强早期分类并实现更充分的早期护理。MWT此前已针对包括区分出血性和缺血性中风能力在内的医学应用进行了评估。本研究的目的是测试MWT结合诊断数学算法是否可作为一种医学筛查工具,用于区分患有创伤性颅内血肿、慢性硬膜下血肿(cSDH)的患者与健康对照组(HC)。使用MWT设备对20例cSDH患者和20例HC进行了测量。使用留一法分析评估诊断算法的准确性。在灵敏度为100%时,特异性为75%,即所有血肿均被检测到,但代价是25%的假阳性(会被过度分类的患者)。考虑到需要在院前环境中识别颅内血肿患者的方法,MWT有望成为提高分类准确性的工具。正在进行进一步研究以评估MWT在其他颅内出血患者中的应用。