Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran; School of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran; Department of Neurology, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Am J Emerg Med. 2022 May;55:174-179. doi: 10.1016/j.ajem.2021.09.074. Epub 2021 Oct 1.
Timely identification and treatment of intracranial hematomas in patients with brain injury is essential for successful treatment. This study evaluates Infra-scanner as a handy medical screening tool for diagnosing, on-site, cerebral hematomas in patients with head injury.
Patients referred to the emergency department of university hospitals with mild to moderate brain trauma, up to 12 h from injury were included. NIR sensors of infra-scan device were placed on the right and left frontal, temporal, peritoneal and occipital parts of the head and light absorption was recorded. Positive or negative cerebral hemorrhage cases were compared with contrast-enhanced CT scan results as the gold standard. Diagnostic parameters of the device and cases related to bleeding were analyzed and reported.
A total of 300 patients were studied. Sensitivity of the infrasound scanner in the Iranian study population was 94.8 (95% CI: 88% -100) and its specificity was 86.9 (95% CI: 79% -99% 99). Negative predictive value (NPV) was 90.3% and positive predictive value (PPV) was 92.9%. Sensitivity in men (95.7%) (95%CI, 90% -1) was more than women (95% CI, 81% -99%)90%. At the ages of less than 36 years, sensitivity (95.3%) and specificity (87.1%) were more than sensitivity (94.4%) and specificity (86.5%) over 36 years old. If the test had been performed in less than / equal to two hours from trauma, the sensitivity (94.9%) and the specificity (92%) were greater than the sensitivity (94.6%) and the specificity (75%) during when the scan had been performed in more than two hours from trauma. In general, in extra-axial bleeding including EDH, SAH, SDH, the sensitivity was 95.1% and the specificity was 84.5%, while in intra-axial bleeding, including ICH and IVH, the sensitivity was lower (93.9%) and the specificity was 91.7. The sensitivity of the device in detecting bleeding in the occipital lobe (95.8%) was higher than other brain lobes.
This study shows that Infra-scanner is useful in initial examination and screening of patients with head injury and can be used as an adjunct to a CT scan or when not available and may allow earlier treatment which reduce the secondary damage to the hematoma.
及时识别和治疗颅脑损伤患者的颅内血肿对于成功治疗至关重要。本研究评估了 Infra-scanner 作为一种简便的医疗筛查工具，用于诊断头部受伤患者的脑内血肿。
将受伤后 12 小时内轻度至中度脑外伤的患者纳入大学医院急诊科。将 Infra-scan 设备的 NIR 传感器放置在头部的右侧和左侧额部、颞部、腹膜和枕部，并记录光吸收情况。将阳性或阴性脑出血病例与增强 CT 扫描结果作为金标准进行比较。分析并报告了设备的诊断参数和与出血相关的病例。
共有 300 例患者接受了研究。在伊朗研究人群中， infrasound 扫描仪的灵敏度为 94.8%（95%CI：88% -100%），特异性为 86.9%（95%CI：79% -99%99）。阴性预测值（NPV）为 90.3%，阳性预测值（PPV）为 92.9%。男性（95.7%）（95%CI，90% -1）的灵敏度高于女性（95%CI，81% -99%）90%。年龄小于 36 岁时，灵敏度（95.3%）和特异性（87.1%）高于 36 岁以上的灵敏度（94.4%）和特异性（86.5%）。如果在创伤后 2 小时内进行测试，灵敏度（94.9%）和特异性（92%）大于在创伤后 2 小时以上进行扫描时的灵敏度（94.6%）和特异性（75%）。总的来说，在包括硬膜下血肿、蛛网膜下腔出血、脑内血肿在内的脑外出血中，灵敏度为 95.1%，特异性为 84.5%，而在脑内出血，包括脑实质出血和脑室内出血中，灵敏度较低（93.9%），特异性为 91.7%。该设备在检测枕叶出血（95.8%）中的灵敏度高于其他脑叶。
本研究表明，Infra-scanner 可用于头部受伤患者的初步检查和筛查，可作为 CT 扫描的辅助手段，也可在无法进行 CT 扫描时使用，从而可能更早地进行治疗，减少血肿的继发性损伤。
