Cerebral hemorrhage, a difficult issue in clinical practice, is often detected and studied with computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET). However, these expensive devices are not readily available in economically underdeveloped regions, and hence are unable to provide bedside and emergency on-site monitoring. The magnetic inductive phase shift (MIPS) is an emerging technology that may become a new tool to detect cerebral hemorrhage and to serve as an inexpensive partial substitute to medical imaging. In order to study a wider band of cerebral hemorrhage MIPS and to provide more useful information for measuring cerebral hemorrhage, we established a cerebral hemorrhage magnetic induction phase shift spectroscopy (MIPSS) detection system. Thirteen rabbits with five cerebral hemorrhage states were studied using a single coil-coil within a 1 MHz-200 MHz frequency range in linear sweep. A feature band (FB) with the highest detection sensitivity and the greatest stability was selected for further analysis and processing. In addition, a maximum conductivity cerebrospinal fluid (CSF) MRI was performed to verify and interpret the MIPSS result. The average phase shift change induced by a 3 ml injection of autologous blood under FB was -7.7503° ± 1.4204°, which was considerably larger than our previous work. Data analysis with a non-parametric statistical Friedman M test showed that in the FB, MIPSS could distinguish the five states of cerebral hemorrhage in rabbits, with a statistical significance of p<0.05. A B-F distribution profile was designed according to the MIPSS under FB that can provide instantaneous diagnostic information about the cerebral hemorrhage severity from a single set of measurements. The results illustrate that the MIPSS detection method is able to provide a new possibility for real-time monitoring and diagnosis of the severity of cerebral hemorrhage.
Cerebral hemorrhage is an important clinical problem that is often monitored and studied with expensive techniques, such as computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET). These devices are not readily available in economically underdeveloped regions of the world and in emergency departments and emergency zones. The magnetic inductive method is an emerging technology that may become a new tool to detect cerebral hemorrhage. In this study, a special phase detector (PD) was developed and used for cerebral hemorrhage detection with the magnetic inductive method. The performance indicated that the PD can achieve phase noise as low as 6 m° and a 4-hour phase drift as low as 30 m° at 21.4 MHz. The noise and drift decreased as the frequency decreased. The performance at 10.7 MHz was slightly better than that of other recently developed phase detection systems. To test the practicality of the system, the PD was used to detect the volume change in a self-made physical model of the brain. The measured phase shift was approximately proportional to the volume change of physiological saline inside the model. The change of the phase shift increased as the volume change and frequency increased. The results are in agreement with those from previous reports. To verify the feasibility of in vivo detection, an autologous blood injection model was established in rabbit brain. The results from the injection group showed a similar trend of increasing phase shift change with increasing injection volume. The average phase shift change induced by a 3-ml injection of blood was 0.502°±0.119°, which was much larger than that of the control group. The measurement system can distinguish a minimal cerebral hemorrhage volume of approximately 0.5 ml. All of the results demonstrated that the PD used with this method can detect cerebral hemorrhage.
Acute cerebral ischemia is an important clinical disease that is usually detected by magnetic resonance imaging or computed tomography. The magnetic inductive phase shift (MIPS) is a new method for detecting cerebral diseases, which is non-invasive, miniaturized, and low-cost. A total of 25 rabbits were studied using a two-coil sensor with a 0.3-200 MHz frequency range, and all the subjects were measured for 1 hour. Based on the rabbit acute cerebral ischemia model, the rabbits were divided into unilateral ligation, bilateral ligation, and non-ligation groups. The results showed that the average MIPS values of the non-ligation, unilateral ligation, and bilateral ligation group were −0.195 ± 0.079 • , −4.873 ± 1.042 • , and −9.165 ± 2.862 • respectively. MIPS distinguished different severities of cerebral ischemia in rabbits with statistical significance (p < 0.05). Laser Doppler flowmetry (LDF) was used as the gold standard for collecting cerebral blood flow data. The strong correlation between the LDF measurements and the phase shift suggested that the phase shift reflects blood flow changes in the brain. Overall, these results suggest that the MIPS detection method has the potential to provide early detection of global cerebral ischemia. Furthermore, this method effectively distinguished different severities of cerebral ischemia. INDEX TERMS Acute cerebral ischemia, magnetic induction phase shift, laser Doppler flowmetry.
Objective: This study aimed to perform experiments to investigate the change trend in brain magnetic induction phase shift (MIPS) during hemorrhagic shock of different degrees of severity and to find the correlation between brain MIPS value and commonly used physiological indicators for detecting shock so as to explore a noninvasive method suitable for prehospital real-time detection of cerebral blood perfusion in hemorrhagic shock. Approach: The self-developed MIPS detection system was used to monitor the brain MIPS value in the whole process of hemorrhagic shock models of rabbits with different degrees of severity (control, mild, moderate, and severe) of shock in real time. Meanwhile, common physiological parameters, including arterial blood lactate (ABL), mean arterial pressure (MAP), heart rate (HR),core body temperature (CBT), regional cerebral blood flow (rCBF), and electroencephalogram (EEG), were also evaluated. Main results: The findings suggested that the brain MIPS value showed a downward trend in the shock process, and the decline degree of the MIPS value positively correlated with the severity of shock. Moreover, it showed a good detection and resolution ability in time/process and severity (P < 0.05). The MIPS values significantly correlated with ABL (P < 0.01), CBT (P < 0.01), and EEG (P < 0.05) at all four shock levels; with MAP (P < 0.05) and rCBF (P < 0.05) in the control, moderate, and severe groups; and with HR (P < 0.01) only in the severe group. Significance: The results demonstrated that the brain MIPS value has the capability of detecting hemorrhagic shock. The MIPS technique is a noninvasive method suitable for prehospital real-time detection of cerebral blood perfusion in hemorrhagic shock.
Objective: To investigate the predictive value of SYNTAX (Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery) score (SS) combined with reactive hyperemia index (RHI) in predicting 2-year major adverse cardiovascular events (MACE) in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI).Background: Both SS and RHI are good predictors of MACE; however, it is unknown whether combining SS and RHI could improve predictability of MACE in patients with ACS undergoing PCI. Methods:We undertook a prospective study in 401 ACS patients that underwent PCI.The RHI-SYNTAX score (RSS) was calculated by categorizing and summing up the RHI and SS of individual patients. Patients with RHI < 1.67 are given 1 point, RHI ≥ 1.67 given 0 points, and those with SS ≤ 22 scored as 0 and SS > 22 as 1 point. Patients were classified into three groups: low RSS (group 0), moderate RSS (group 1), and high RSS (group 2).Results: Among patients in the low, moderate, and high groups, the 2-year rates of MACE were 5.50, 10.66, and 23.33%, respectively (p < .0001). Total revascularization rates were 1.83, 2.54, and 8.89%, respectively (p = .015). Ischemic stroke rates were 0.00, 3.67, and 5.56%, respectively (p = .031). By multivariate analysis, the RSS was an independent predictor of 2-year MACE (hazard ratio: 2.09, 95% CI: 1.36-3.21, p = .001).Receiver-operator characteristic analysis indicated that the area under the curve significantly improved from 0.63 to 0.69, when RHI was added to SS (p < .0001). Conclusions: RSS is correlated with 2-year MACE in patients presenting with ACS undergoing PCI. K E Y W O R D S acute coronary syndrome, percutaneous coronary intervention, reactive hyperemia index, SYNTAX score
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