Application of a time-resolved optical brain imager for monitoring cerebral oxygenation during carotid surgery
Application of a time-resolved optical brain imager for monitoring cerebral oxygenation during carotid surgery
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DOI：
10.1117/1.jbo.17.1.016002
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发表时间：
2012-01-01
影响因子：
3.5
通讯作者：
Maniewski, Roman
中科院分区：
文献类型：
--
作者：
Kacprzak, Michal;Liebert, Adam;Maniewski, Roman
最近的研究表明，头部的时间分辨光学测量可以估计吸收系数随深度辨别的变化。因此，使用这种先进的技术可以评估颅内组织特有的组织氧合变化，并且这种方法使我们能够避免脑外组织氧合变化对测量信号的影响。我们报告在颈动脉内膜切除术期间进行的时间分辨光学成像的结果。这种手术仍然是治疗颈动脉狭窄的“金标准”，术中脑氧合监测可以提高手术的安全性。手术室内采用时间分辨光学成像仪。该仪器允许同时获取两个半球上两个波长的光子的32种飞行时间分布。利用测量到的光子飞行时间分布的统计矩来估计吸收系数随深度的变化。获得颈动脉交叉夹持过程中脑外和脑内氧和脱氧血红蛋白变化的时间过程。在头部的大片区域观察到氧合血红蛋白浓度的下降和脱氧血红蛋白浓度的增加。在颈动脉夹持部位的同侧半球观察到大的变化。对侧部位的振幅变化较小。我们还发现，从脑组织中估计的血红蛋白信号的变化对颈内动脉的夹紧非常敏感，而对颈外动脉的夹紧的敏感性有限。我们得出结论，术中多通道测量允许脑组织血流动力学成像。然而，在颈动脉手术中监测大脑时，单通道测量可能就足够了。(c) 2012年中国光学仪器工程师学会（SPIE）；(jbo.17.1.016002 DOI: 10.1117/1.)
Recent studies have shown that time-resolved optical measurements of the head can estimate changes in the absorption coefficient with depth discrimination. Thus, changes in tissue oxygenation, which are specific to intracranial tissues, can be assessed using this advanced technique, and this method allows us to avoid the influence of changes to extracerebral tissue oxygenation on the measured signals. We report the results of time-resolved optical imaging that was carried out during carotid endarterectomy. This surgery remains the "gold standard" treatment for carotid stenosis, and intraoperative brain oxygenation monitoring may improve the safety of this procedure. A time-resolved optical imager was utilized within the operating theater. This instrument allows for the simultaneous acquisition of 32 distributions of the time-of-flight of photons at two wavelengths on both hemispheres. Analysis of the statistical moments of the measured distributions of the time-of-flight of photons was applied for estimating changes in the absorption coefficient as a function of depth. Time courses of changes in oxy- and deoxyhemoglobin of the extra- and intracerebral compartments during cross-clamping of the carotid arteries were obtained. A decrease in the oxyhemoglobin concentration and an increase in the deoxyhemoglobin concentrations were observed in a large area of the head. Large changes were observed in the hemisphere ipsilateral to the site of clamped carotid arteries. Smaller amplitude changes were noted at the contralateral site. We also found that changes in the hemoglobin signals, as estimated from intracerebral tissue, are very sensitive to clamping of the internal carotid artery, whereas its sensitivity to clamping of the external carotid artery is limited. We concluded that intraoperative multichannel measurements allow for imaging of brain tissue hemodynamics. However, when monitoring the brain during carotid surgery, a single-channel measurement may be sufficient. (c) 2012 Society of Photo-Optical Instrumentation Engineers (SPIE). [DOI: 10.1117/1.JBO.17.1.016002]