Feasibility of near-infrared spectroscopic tomography for intraoperative functional cerebral monitoring: a primate study.
Feasibility of near-infrared spectroscopic tomography for intraoperative functional cerebral monitoring: a primate study.
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近红外光谱断层扫描用于术中功能性脑监测的可行性：一项灵长类动物研究。
DOI：
10.1016/j.jtcvs.2014.07.041
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Barbour,RandallL
中科院分区：
文献类型：
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作者：
Lee,DanielC;Gevorgyan,Tigran;Graber,HarryL;Pfeil,DouglasS;Xu,Yong;Mangla,Sundeep;Barone,FrankC;Libien,Jenny;Charchaflieh,Jean;Kral,JohnG;Ramirez,SergioA;Simpson,LeRone;Barbour,RandallL
心脏手术期间经常发生的对心血管系统的广泛操纵可能会使大脑暴露于可能被证明是有害的血液供应的变化。作为开发适合于监测这种变化的资源的第一步，我们检测了灵长类动物模型大脑中诱导的血液动力学事件，使用高密度近红外光谱与断层重建方法相结合，并使用已建立的放射学和组织学技术验证结果。在大脑暴露于诱导缺血和其他急性事件的麻醉帽子猕猴中进行红外光谱分析（270个源-检测器通道阵列）。比较分析（精确二项检验）应用于事件前后和大脑半球之间的重建三维图像，结合术后磁共振成像，并对猕猴的大脑进行死后组织病理学检查，以记录和验证由光学发现揭示的空间特征。在响应所执行的操作，揭示了在重建的三维图像、猕猴脑的磁共振成像和死后组织病理学检查结果之间的实质性一致性。同时被视为操纵血红蛋白浓度和相关的氧合水平增加或减少时，无论是双边或限制到一个指定的semiple.ConclusionsContinuous近红外光谱断层扫描已被证明准确地捕捉和本地化脑缺血，血管扩张，出血在灵长类动物在真实的时间。这些结果直接适用于临床术中脑功能监测。
ObjectiveThe wide-ranging manipulations to the cardiovascular system that frequently occur during cardiac surgery can expose the brain to variations in its blood supply that could prove deleterious. As a first step to developing a resource suitable for monitoring such changes, we detected the hemodynamic events induced in the brain of a primate model, using high-density near-infrared spectroscopy combined with tomographic reconstruction methods and validated the findings using established radiologic and histologic techniques.MethodsContinuous monitoring of the relative changes in the components of the cerebral hemoglobin signal was performed using high-density near-infrared spectroscopy (270 source-detector channel array) in anesthetized bonnet macaques with the brain exposed to induced ischemia and other acute events. A comparative analysis (exact binomial test) applied to reconstructed 3-dimensional images before and after the events and between cerebral hemispheres, combined with postprocedure magnetic resonance imaging, and postmortem histopathologic examination of the macaques' brains was performed to document and validate the spatial features revealed by the optical findings.ResultsRelative changes in the measured and calculated components of the hemoglobin signal, in response to the performed manipulations, revealed substantial concurrence among the reconstructed 3-dimensional images, magnetic resonance imaging of the macaques' brains, and postmortem histopathologic examination findings. Concurrence was seen when the manipulated hemoglobin concentration and associated oxygenation levels were either increased or decreased, and whether they were bilateral or restricted to a specified hemisphere.ConclusionsContinuous near-infrared spectroscopy tomography has been shown to accurately capture and localize cerebral ischemia, vasodilatation, and hemorrhage in primates in real time. These findings are directly applicable to clinical intraoperative functional cerebral monitoring.