Spinal cord integrity monitoring by adaptive coherence measurement.
Spinal cord integrity monitoring by adaptive coherence measurement.
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DOI：
10.1016/j.jneumeth.2010.07.035
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发表时间：
2010-10-30
影响因子：
3
通讯作者：
All, A. H.
中科院分区：
文献类型：
--
作者：
Sherman, D. L.;Wuyyuru, V.;Brooke, M. Jason;Zhang, H. X.;Sepkuty, J. P.;Thakor, N. V.;Natarajan, A.;All, A. H.
常规脊髓手术中的损伤可能会对手术患者造成毁灭性后果。通过体感诱发电位（SEP）进行脊髓监测仍然是预防严重损伤的可行方法。自适应相干估计（ACE）是一种通过逐次滤波器夹带迭代计算信号匹配质量的方法。在这里，我们比较了ACE的检测速度与传统的幅度测量。同时运行ACE的绝对幅度和振幅以及斜率变化检测器算法（Farley-Hinich），以确定发生显著变化的最早时间。ACE算法的标准误差接近振幅测量的十分之一。由于ACE算法在基线测量期间实现了低方差，因此我们能够实现损伤的快速检测。对于绝对幅度检测，ACE比20 g损伤重量级别的幅度更快。平均需要10个时期才能用自适应相干检测损伤，而用标准幅度度量（使用绝对幅度变化）检测损伤则需要近19个时期。使用斜率变化的突变检测方法表明，ACE提供了比幅度更有利的检测能力。此外，ACE和振幅单独使用的ROC曲线显著增加（P<0.05）。自适应相干方法具有良好的检测能力，是对传统振幅法的一种很好的补充，可用于捕捉SEP中与损伤相关的变化。自适应相干仍然是一种可行的方法，快速，准确地检测脊髓损伤。
Injury during routine spinal cord procedures could result in devastating consequences for the surgical patient. Spinal cord monitoring through somatosensory evoked potentials (SEPs) remains a viable method for prevention of serious injury. The adaptive coherence estimation (ACE) is a method to iteratively calculate signal match quality through successive filter entrainment. Here we compare the speed of detection with ACE to conventional amplitude measurements. Both absolute magnitude of ACE and amplitude as well as slope change detector algorithm (Farley-Hinich) was run as well to determine the earliest time when a significant change occurred. The standard error for the ACE algorithm is close to one tenth of the amplitude measure, Since the ACE algorithm achieved low variance during baseline measurement, we were able to achieve rapid detection of injury. For absolute magnitude detection ACE was faster than amplitude for the 20g injury weight class. It took an average of 10 epochs to detect the injury with adaptive coherence and nearly 19 with standard amplitude metrics using absolute magnitude changes. Abrupt change detection methods using slope change show that ACE provides more favorable detection capabilities comparable to amplitude. Additionally, there was a significant increase in the ROC curve between ACE and amplitude alone (P<0.05). Because of its excellent detection capabilities, the adaptive coherence method provides an excellent supplement to traditional amplitude for capturing injury-related changes in SEPs. Adaptive coherence remains a viable method for rapidly and accurately detecting spinal injury.
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