Kapoor Indu, Pandit Sneha, Prabhakar Hemanshu, Mahajan Charu
Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
Indian J Crit Care Med. 2023 Jan;27(1):64-66. doi: 10.5005/jp-journals-10071-24376.
Midline shift (MLS) of the brain is an important clinical finding diagnosed on computed tomography (CT) imaging and transcranial sonography (TCS) can help diagnose MLS at the bedside and facilitate interventions to improve outcomes. The study aimed to find an association between TCS- and CT-based assessments of MLS in patients with traumatic brain injury (TBI).
We included all adult patients with moderate-to-severe TBI of either gender, aged between 18 and 65 years, undergoing intracranial surgery under general anesthesia over a period of 3 months. Consciousness was assessed with the help of the Glasgow coma scale (GCS) and Glasgow coma scale-pupillary (GCS-P) score. We calculated MLS using a CT scan and TCS. Bland Altman graph along with Pearson's and Spearman's coefficient tests was used.
A total of 17 patients were analyzed in this study. The MLS was 0.52 ± 0.90 cm using TCS and 0.58 ± 0.39 cm using CT scan. The Pearson's correlation coefficient ( ) of the difference between MLS measured by TCS and CT imaging was 0.002 ( < 0.05).
Transcranial sonography could detect MLS in patients with TBI, provided a minimum time window is used between MLS measurements by TCS and CT scan.
Kapoor I, Pandit S, Prabhakar H, Mahajan C. Comparison between Transcranial Sonography and Computerized Tomography Scans to Assess the Midline Shift in Patients with Traumatic Brain Injury. Indian J Crit Care Med 2023;27(1):64-66.
脑中线移位（MLS）是计算机断层扫描（CT）成像诊断的一项重要临床发现，经颅超声检查（TCS）有助于在床边诊断MLS，并促进采取干预措施以改善预后。本研究旨在探讨创伤性脑损伤（TBI）患者基于TCS和CT的MLS评估之间的相关性。
我们纳入了所有年龄在18至65岁之间、接受全身麻醉下颅内手术的成年中重度TBI患者，研究为期3个月。借助格拉斯哥昏迷量表（GCS）和格拉斯哥昏迷量表-瞳孔（GCS-P）评分评估意识状态。我们使用CT扫描和TCS计算MLS。采用Bland Altman图以及Pearson和Spearman系数检验。
本研究共分析了17例患者。使用TCS测得的MLS为0.52±0.90 cm，使用CT扫描测得的MLS为0.58±0.39 cm。TCS测量的MLS与CT成像测量的MLS差值的Pearson相关系数（ ）为0.002（<0.05）。
经颅超声检查可检测TBI患者的MLS，前提是在TCS测量MLS和CT扫描之间使用最短时间窗。
卡普尔I，潘迪特S，普拉巴卡尔H，马贾恩C。经颅超声检查与计算机断层扫描评估创伤性脑损伤患者中线移位的比较。《印度重症监护医学杂志》2023；27(1):64 - 66。
