Detecting and Monitoring Stroke in China Using a Low-Cost, Portable Microwave Scanner (DeMoStroke)

中风事件的影响是巨大的：每年有500万人死于中风事件，另有500万人永久残疾，在西方世界，中风在急性死亡原因中排名第三，在神经功能障碍原因中排名第一。然而，其影响和后果对发展中国家的破坏性更大，据世卫组织估计，2001年中风死亡人数占全世界中风死亡人数的85.5%，残疾调整寿命年(即寿命损失年数和残疾寿命年数)几乎是高收入国家的七倍。特别是在中国身上，中风是主要的死因，而且比西方世界更早发生。它的治疗在很大程度上依赖于诊断方法提供的信息，这些信息对于指导医学专家选择治疗策略和评估其有效性是必要的。该项目将基于英国和中国项目合作伙伴的现有专业知识，开发一种便携式、低成本的系统，可以检测到中风的发生，并使用微波技术监测中风的演变及其治疗。拟议的系统将使用低功率、非电离无线电波(微波)以准确的方式对中风的发生和演变进行成像，从而消除对昂贵的成像系统(如CT扫描)的需求，因为这将导致治疗决策的重大延误。例如，该系统可以在救护车内使用，比医院内的CT扫描仪更早地确定中风的类型。这对缺血性中风患者(占总病例的80%以上)尤其重要，对他们来说，及早发现对于溶栓治疗(即血液稀释剂)至关重要(即血液稀释剂可以溶解因缺血性中风而导致的血管凝块，但会加剧出血性中风时血管破裂的情况)。此外，通过在家中为患者提供护理诊断工具，建议的方法可以导致在急性后阶段对中风进行更有效的管理，从而提高患者的潜在康复。因此，在CT或MRI设备稀缺或不可用的社区，例如中国和其他官方发展援助国家的欠发达或农村地区，该扫描仪可以为中风的治疗和康复带来革命性的变化。该项目将依靠英国学术界和工业界在微波成像算法和仪器方面的专业知识来开发微波设备。除了提供微波医学成像方面的学术专业知识外，该项目的ODA合作伙伴还将通过医院和医疗中心网络以及与中国30个城市的35多家医院合作规划临床试验，加快拟议设备进入临床使用的途径。虽然该项目是在中国交付的，但该项目可以在许多发展中国家产生影响，在这些国家，中风也正在成为年轻人口的健康威胁(例如南亚国家)，因为目标设备将是负担得起的，而且使用起来足够简单。

The impact of stroke incidents is immense: five million people die and another five million are permanently disabled every year due to stroke incidents, and stroke is placed third among reasons for acute death and first among reasons for neurological dysfunction in the western world. Its impact and consequences, however, are even more devastating in developing countries, where according to WHO estimates, death from stroke accounted for 85.5% of stroke deaths worldwide in 2001, and the number of disability-adjusted life years (DALYs), i.e. years of life lost and years lived with disability, was almost seven times higher than in high-income countries. In China, in particular, stroke is the leading cause of death, and it strikes earlier in life than it does in the western world. Its treatment relies to a great extent on the information provided by diagnostic methodologies, which are necessary to guide medical experts in choosing a treatment strategy and to assess its efficiency.This project will build on existing expertise by the project partners in the UK and China towards the development of a portable and low-cost system which can detect the occurrence, and monitor the evolution of stroke and its treatment using microwave technology. The proposed system will use low-power, non-ionizing radio waves (microwaves) to image the occurrence and evolution of stroke in an accurate manner, thereby removing the need for expensive imaging systems (such as CT scans) which would result in significant delays in treatment decisions.This approach can address several clinical needs. For example, the system can be used inside an ambulance to determine the type of stroke much earlier than CT scanners inside a hospital. This is particularly important for ischemic stroke patients (which account for over 80% of total cases), for which early detection is crucial for thrombolytic treatment (i.e. blood thinners that can dissolve clots in blood vessels due to ischemic stroke but would worsen the condition of a blood vessel rupture occurring in hemorrhagic stroke). Moreover, by serving as a point of care diagnostic tool for patients at their homes, the proposed approach can lead to more efficient management of stroke in the post-acute stage, which can improve the potential recovery of the patient. The scanner can therefore revolutionise stroke therapy and recovery in communities where CT or MRI equipment is scarce or not available, such as underdeveloped or rural areas in China and other ODA countries.The project will develop the microwave device relying on academic and industrial UK expertise in microwave imaging algorithms and instrumentation. In addition to offering academic expertise in microwave medical imaging, the project's ODA partners will accelerate the proposed device's pathway to clinical use through a network of hospitals and medical centres and cooperation with over 35 hospitals across 30 cities in China in the planning of clinical trials. Although delivered in China, the project can make a difference in many developing countries where stroke is emerging as a health threat also for younger populations (e.g. South Asian countries), as the targeted device will be affordable and simple enough to use.