Artikel
Intraoperative imaging of cortical perfusion by time resolved thermography and multivariate data analysis
Suche in Medline nach
Autoren
Veröffentlicht: | 16. September 2010 |
---|
Gliederung
Text
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.