Thermography - a valuable tool to test hydrocephalus shunt patency
Thermography - a valuable tool to test hydrocephalus shunt patency
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DOI：
10.1007/s00701-005-0608-1
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发表时间：
2005-11-01
影响因子：
2.4
通讯作者：
Uhl, E
中科院分区：
文献类型：
--
作者：
Goetz, C;Foertsch, D;Uhl, E
导论.脑积水患者的分流功能大多通过临床检查和重复的头颅CT（CCT）来证实。由于多次照射的缺点，特别是在儿童中，我们的目的是引入视频热成像作为一种简单和非侵入性的方法来评估分流功能。对54例接受分流术治疗脑积水的患者进行了测试。38例患者植入脑室-腹腔分流管，16例患者植入脑室-心房分流管。最近的CCT扫描可用于所有患者，并作为对照。所有患者均未出现分流功能障碍的临床体征。通过经校准的红外摄像机实时记录瓣膜远端引流导管覆盖的皮肤温度。在用冰袋冷却瓣膜下游皮肤区域1分钟后，用热成像仪记录下游区域皮肤温度的变化。信号被传送到电视屏幕上并记录在录像带上。通过对所获得的伪彩色图像进行离线分析，可以测量皮肤温度的0.1摄氏度的变化。研究区域的温度分布显示，冷却后48例患者的皮肤温度根据下游导管段的位置显著降低。6例患者的皮肤温度保持恒定，尽管临床评价和CCT扫描显示没有分流功能障碍的迹象。热成像可证实85%以上的患者分流通畅。红外热成像是一种有价值的和有前途的工具，取代CCT扫描作为筛选方法，以测试分流功能的脑积水患者。
Introduction. Shunt-function in hydrocephalic patients is verified by clinical examination and repeated cranial computed tomography (CCT) in most cases. Because of the disadvantages of multiple radiation especially in children it was our aim to introduce video-thermography as a simple and non-invasive methodology to evaluate shunt function.Methods. 54 patients treated with shunts for hydrocephalus were tested. A ventriculo-peritoneal shunt had been implanted in 38 patients, a ventriculo-atrial shunt in 16 patients. Recent CCT-scans were available for all patients and served as control. None of the patients presented with clinical signs of shunt-dysfunction. The temperature of the skin covering the drainage catheter distal to the valve was recorded real-time by a calibrated infrared camera. After cooling the skin area downstream of the valve for exactly 1 min with an ice pack, changes of the skin temperature in the area downstream were registered by a thermocamera. The signals were transferred to a video screen and recorded on video-tape. By off-line analysis of the obtained pseudo colour images variations of 0.1 degrees C in skin temperature could be measured.Results. Temperature distribution of the area under investigation revealed a significant reduction of the skin temperature according to the location of the downstream catheter segment in 48 patients after cooling. In 6 patients skin temperature remained constant, although clinical evaluation and CCT-scan showed no signs of shunt dysfunction. Shunt patency could be verified in more than 85% of the patients by thermal imaging.Conclusion. Infrared-thermography is a valuable and promising tool for replacing CCT-scanning as a screening method to test shunt function in hydrocephalic patients.