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在急诊科使用近红外光谱法检测颅内血肿。

Detection of intracranial hematomas in the emergency department using near infrared spectroscopy.

作者信息

Kontojannis Vassilios, Hostettler Isabel, Brogan Robert James, Raza Muhammad, Harper-Payne Abby, Kareem Haider, Boutelle Martyn, Wilson Mark

机构信息

a Neurosurgery , Imperial College London Centre for Neuroscience , London , UK.

b Neurosurgery , Imperial College Healthcare NHS Trust , London , UK.

出版信息

Brain Inj. 2019;33(7):875-883. doi: 10.1080/02699052.2019.1610796.

Abstract

: Traumatic brain injury (TBI) is one of the most important causes of morbidity and mortality in our society. The development of near infrared technology for the detection of intracranial hematomas may assist earlier diagnosis of TBI. This in turn may enable earlier targeted treatments minimizing the harm and subsequent social and economic effects of TBI. : A handheld, noninvasive Near Infrared Spectroscopy device, Infrascanner 2000, (Infrascan Inc., Philadelphia, PA, USA) was used in a major trauma center to screen for traumatic intracranial hematomas. The Infrascanner was used successfully in 205 patients on their arrival in the emergency department prior to CT head. : In the whole cohort, sensitivity was 75%, specificity was 50.43%, with negative predictive value 72.84%, and positive predictive value 53.23%. In 45 patients, where the volume of blood was >3.5mL, the sensitivity was 89.36%, specificity 48.73% with negative predictive value 93.9% and positive predictive value 34.15%. : The Infrascanner has a relatively high specificity and negative predictive value; therefore, it could in association with the Neurological examination, help in the triage of the trauma patient with potential brain injury. Further investigation is necessary to determine the use of Infrascanner 2000 as a diagnostic method in TBI.

摘要

创伤性脑损伤(TBI)是我们社会中发病和死亡的最重要原因之一。用于检测颅内血肿的近红外技术的发展可能有助于TBI的早期诊断。这反过来可能使早期靶向治疗成为可能,从而将TBI的危害以及随后的社会和经济影响降至最低。:在一家大型创伤中心使用了一种手持式非侵入性近红外光谱设备Infrascanner 2000(美国宾夕法尼亚州费城的Infrascan公司)来筛查创伤性颅内血肿。Infrascanner在205名患者抵达急诊科后、进行头部CT扫描之前成功使用。:在整个队列中,敏感性为75%,特异性为50.43%,阴性预测值为72.84%,阳性预测值为53.23%。在45名血肿体积>3.5mL的患者中,敏感性为89.36%,特异性为48.73%,阴性预测值为93.9%,阳性预测值为34.15%。:Infrascanner具有相对较高的特异性和阴性预测值;因此,它可以与神经学检查相结合,帮助对可能存在脑损伤的创伤患者进行分诊。有必要进行进一步研究以确定Infrascanner 2000作为TBI诊断方法的用途。

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