gms | German Medical Science

61st Annual Meeting of the German Society of Neurosurgery (DGNC) as part of the Neurowoche 2010
Joint Meeting with the Brazilian Society of Neurosurgery on the 20 September 2010

German Society of Neurosurgery (DGNC)

21 - 25 September 2010, Mannheim

Intraoperative imaging of cortical perfusion by time resolved thermography and multivariate data analysis

Meeting Abstract

  • Matthias Kirsch - Klinik und Poliklinik für Neurochirurgie, Carl Gustav Carus Universitätsklinikum, Technische Universität Dresden, Deutschland
  • Cindy Urbaneck - Klinik und Poliklinik für Neurochirurgie, Carl Gustav Carus Universitätsklinikum, Technische Universität Dresden, Deutschland
  • Stephan B. Sobottka - Klinik und Poliklinik für Neurochirurgie, Carl Gustav Carus Universitätsklinikum, Technische Universität Dresden, Deutschland
  • Edmund Koch - Clinical Sensoring and Monitoring, Carl Gustav Carus Universitätsklinikum, Technische Universität Dresden, Deutschland
  • Gabriele Schackert - Klinik und Poliklinik für Neurochirurgie, Carl Gustav Carus Universitätsklinikum, Technische Universität Dresden, Deutschland
  • Gerald Steiner - Clinical Sensoring and Monitoring, Carl Gustav Carus Universitätsklinikum, Technische Universität Dresden, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocV1593

DOI: 10.3205/10dgnc068, URN: urn:nbn:de:0183-10dgnc0680

Published: September 16, 2010

© 2010 Kirsch et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: A new approach of cortical perfusion imaging is evaluated using high sensitive thermography in conjunction with multivariate statistical data analysis.

Methods: Thermographic imaging was performed under regular illumination in the operating theatre. The cortical surface was imaged for 2–4 min in patients who had undergone a decompressive hemicraniectomy for malignant MCA stroke. A “cold” bolus was applied via a central venous line (injection of regular saline). The local temperature changes caused by the cold bolus were imaged and transferred to false color images. Immediately after the injection a sequence of more than 700 thermographic images were recorded within 2 minutes. The recorded data cube underwent a principal component analysis (PCA) in order to select slight changes of the cortical temperature caused by the cold bolus.

Results: Six patients were investigated that had undergone a decompressive craniectomy. The PCA analysis reveals that 13 seconds after injection the temperature of blood vessels is shortly decreased followed by an increase to the temperature before the cold bolus was injected. Although unprocessed cortical imaging was able to visualize the infarction zone, only postprocessing was able to identify a zone resembling the penumbra. Regular background fluctutations were easily discernable, such as heart rate and breathing.

Conclusions: Thermographic imaging has the potential as an intraoperative tool to perform online optic analysis of cortical blood flow in a non-invasive manner without fluorescence markers. We provide the first in vivo application of multivariate thermography imaging and envisage that monitoring of the penumbra will be possible, that regions of otherwise unidentifiable interventions can be targeted, such as implantation of ICP-monitoring devices or identification of the cortical distribution of temporarily occluded vessels.