Yang Jun, Zhao Hui, Li Gen, Ran Qisheng, Chen Jingbo, Bai Zelin, Jin Gui, Sun Jian, Xu Jia, Qin Mingxin, Chen Mingsheng
College of Biomedical Engineering, Army Medical University, Chongqing, China.
State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Surgery Research, Third Military Medical University, Chongqing, China.
PeerJ. 2019 Apr 12;7:e6717. doi: 10.7717/peerj.6717. eCollection 2019.
Closed cerebral hemorrhage (CCH) is a common symptom in traumatic brain injury (TBI) patients who suffer intracranial hemorrhage with the dura mater remaining intact. The diagnosis of CCH patients prior to hospitalization and in the early stage of the disease can help patients get earlier treatments that improve outcomes. In this study, a noncontact, portable system for early TBI-induced CCH detection was constructed that measures the magnetic induction phase shift (MIPS), which is associated with the mean brain conductivity caused by the ratio between the liquid (blood/CSF and the intracranial tissues) change. To evaluate the performance of this system, a rabbit CCH model with two severity levels was established based on the horizontal biological impactor BIM-II, whose feasibility was verified by computed tomography images of three sections and three serial slices. There were two groups involved in the experiments (group 1 with 10 TBI rabbits were simulated by hammer hit with air pressure of 600 kPa by BIM-II and group 2 with 10 TBI rabbits were simulated with 650 kPa). The MIPS values of the two groups were obtained within 30 min before and after injury. In group 1, the MIPS values showed a constant downward trend with a minimum value of -11.17 ± 2.91° at the 30th min after 600 kPa impact by BIM-II. After the 650 kPa impact, the MIPS values in group 2 showed a constant downward trend until the 25th min, with a minimum value of -16.81 ± 2.10°. Unlike group 1, the MIPS values showed an upward trend after that point. Before the injury, the MIPS values in both group 1 and group 2 did not obviously change within the 30 min measurement. Using a support vector machine at the same time point after injury, the classification accuracy of the two types of severity was shown to be beyond 90%. Combined with CCH pathological mechanisms, this system can not only achieve the detection of early functional changes in CCH but can also distinguish different severities of CCH.
闭合性脑出血（CCH）是创伤性脑损伤（TBI）患者的常见症状，这些患者颅内出血但硬脑膜保持完整。在住院前和疾病早期对CCH患者进行诊断有助于患者获得改善预后的早期治疗。在本研究中，构建了一种用于早期检测TBI诱发的CCH的非接触式便携式系统，该系统测量磁感应相移（MIPS），其与由液体（血液/脑脊液和颅内组织）变化比率引起的平均脑电导率相关。为了评估该系统的性能，基于水平生物撞击器BIM-II建立了具有两种严重程度水平的兔CCH模型，通过三个截面和三个连续切片的计算机断层扫描图像验证了其可行性。实验分为两组（第1组10只TBI兔，通过BIM-II以600 kPa气压锤击模拟；第2组10只TBI兔，以650 kPa模拟）。在受伤前后30分钟内获取两组的MIPS值。在第1组中，MIPS值呈持续下降趋势，在BIM-II以600 kPa撞击后第30分钟时达到最小值-11.17±2.91°。在650 kPa撞击后，第2组的MIPS值呈持续下降趋势，直到第25分钟，最小值为-16.81±2.10°。与第1组不同，此后MIPS值呈上升趋势。在受伤前，第1组和第2组的MIPS值在30分钟测量时间内均无明显变化。在受伤后的同一时间点使用支持向量机，两种严重程度类型的分类准确率均超过90%。结合CCH病理机制，该系统不仅可以实现对CCH早期功能变化的检测，还可以区分不同严重程度的CCH。
