基于对侧半球抵消的磁感应相位移检测脑出血的技术研究

The enlargement of hematoma after intracranial hemorrhage (ICH) and recurrent hematoma after operation are the most important factors to increasing mortality and morbidity. Effective methods of continuous monitoring and early warning in ICH is lacking in clinic. Magnetic induction phase shift (MIPS) which measured by the electromagnetic properties of biological tissues is a noncontact, noninvasive, continuous and fast detection technology, and undoubtedly becomes one of the best method for ICH detection and monitoring. The existing MIPS detection mode is not sensitive to the volume change of hematoma. Given ICH physiological features and the brain structure, we found that the contra-lateral hemisphere cancellation mode can boost MIPS sensitivity more than 10 times. On the basis of our up-front work, using the electromagnetic as a guidance, the CHCM coil as a tool, the already established MIPS measurement system as a platform, and the ICH animal mode as the research object, this study is to measure the quantitative relation between the MIPS and the bleeding volume, and explain the rule of the bleeding leading to MIPS changes, via radiologic observation, intracranial pressure monitoring, and comparison measurement. At last, the MIPS feature points corresponding to the mutation of ICP and midline shift are looked for by statistical analysis and signal processing. The study results are expected to provide a new method for ICH monitoring and early warning in clinic.

脑出血（ICH）后血肿扩大以及术后二次出血是增加致残率和致死率的最重要因素，而目前临床上缺乏有效的脑出血早期预警和持续监护方法。磁感应相位移（MIPS）技术基于生物组织的电磁特性，具有非接触、无创伤、连续快速测量等特点，是实现脑出血监护的最佳方法之一。已有MIPS检测方法灵敏度低，对出血量的变化不敏感。鉴于ICH的病理机制以及脑结构特点，前期实验发现采用对侧半球抵消方法（CHCM）可以将MIPS检测方式的灵敏度提高一个数量级。本课题拟在已研究基础上，以电磁仿真为指导，以CHCM线圈为工具，以已建立的MIPS测量系统为平台，以动物脑出血模型为研究对象，测量出血量与MIPS之间的定量关系；通过影像学观察、颅内压监测以及对比实验等手段研究MIPS随出血量变化的规律；再通过统计分析和信号处理寻找中线移位以及颅内压突变对应的MIPS特征点。本课题研究成果有望为临床ICH的预警和监护提供一种新的方法。

脑出血（ICH），是指脑实质内血管破裂引起的出血，起病急骤、病情凶险、致残率和死亡率非常高。当前脑出血的检测主要依靠CT、MRI等影像设备，但其无法满足连续监护，急救后送以及早期检测的需要。本项目基于电磁感应检测的原理，设计了CHCM线圈，建立了基于CHCM的磁感应相位移(MIPS)测量系统。使用该系统完成了家兔ICH模型的MIPS，ICP测量实验，得到了家兔脑出血模型MIPS和出血量之间的对应关系。完成了巴马香猪的ICH的MIPS测量实验。得到了巴马香猪脑出血模型MIPS和出血量之间的对应关系。经过大量的动物实验以及数据统计与分析得出结论：在脑出血代偿期MIPS随着出血量的增加逐渐下降，而当脑功能代偿结束后MIPS随着出血量的增加逐渐小幅上升。但是具体上升或下降的度数会跟被测头颅与线圈之间的距离有关系，被测头颅距离接收线圈越近，灵敏度越高；反之下降。该结论可以为下一步磁感应的临床脑出血检测提供重要的理论指导。