MICA: Early thrombolytic intervention in acute stroke by imaging with Electrical Impedance Tomography

电阻抗断层扫描（EIT）是一种新型的医学成像方法，通过在身体周围放置电极环，快速产生断层扫描“切片”图像。它安全、便携、便宜。主申请人的小组已经证明，EIT可以在中风、癫痫等神经系统疾病和动物模型的正常活动中快速成像，并开发了在头型水箱中运行良好的系统。溶栓治疗是一种治疗急性中风的新方法，必须在三小时内进行治疗，但其使用受到限制，因为在进行治疗之前必须对头部进行成像。这是因为突然出现的虚弱或残疾，表现为中风，可能是由于大脑的一部分血液不足或出血进入大脑。在影像学检查是否出血之前，不能使用溶凝剂，因为它可能会使出血更严重，并带来灾难性的后果。EIT有潜力提供一种廉价的便携式设备，用于救护车或全科医生手术，通过在接触点提供成像，将彻底改变这种药物在急性中风中的管理。这可以通过互联网传递给放射科医生，然后放射科医生可以允许护理人员在救护车上或远程中心给药。该计划是在成像和头盔或头罩的设计上进行三项技术改进，头盔或头罩包含精确的脑电刺激所需的接触，并在水箱、麻醉大鼠和人类患者研究中客观地进行测试。最终的结果将是一个新的EIT系统设计，优化急性卒中成像，并在大约30名患者中对其性能进行严格评估。

Electrical Impedance Tomography (EIT) is a novel medical imaging method in which tomographic "slice" images are rapidly produced using rings of electrodes placed around the body. It is safe, portable and inexpensive. The principal applicant's group has demonstrated that EIT can rapidly image functional brain activity in neurological conditions like stroke, epilepsy and normal activity in animal models and has developed systems which work well in head-shaped tanks. Thrombolytic "clot-busting" treatment is a new treatment for acute stroke which must be given within three hours, but its take-up has been restricted because it is essential to undertake imaging of the head before it can be administered. This is because a sudden onset of weakness or disability which appears as a stroke, can be due to insufficient blood to a part of the brain or else bleeding into the brain. The clot-dissolving agent cannot be given until imaging has been used to assess if a bleed has occurred, as it could make the bleeding much worse with catastrophic consequences. EIT has the potential to provide an inexpensive portable unit for use in ambulances or GP surgeries which would revolutionise administration of this drug in acute stroke by providing imaging at the point of contact. This could be relayed over the internet to a radiologist who could then give permission for a paramedic to give the drug in the ambulance or in a remote centre. The plan is to make three technical improvements in imaging and design of a helmet or headnet containing the contacts needed for accurate brain EIT and test these objectively in tanks, anaesthetised rats and human patient studies. The final outcome will be a new EIT system design optimised for imaging in acute stroke, with rigorous evaluation of its performance in about 30 patients.