RESUMO
An epilepsy patient with recurring sensorimotor seizures involving the left hand every 10 min, was imaged with a hyperspectral camera during surgery. By calculating the changes in oxygenated, deoxygenated blood, and total blood volume in the cortex, a focal increase in oxygenated and total blood volume could be observed in the sensory cortex, corresponding to the seizure-onset zone defined by intracranial electroencephalography (EEG) findings. This probably reflects very local seizure activity. After multiple subpial transections in this motor area, clinical seizures abated.
Assuntos
Mapeamento Encefálico , Processamento de Imagem Assistida por Computador , Córtex Motor/cirurgia , Convulsões/cirurgia , Adolescente , Mapeamento Encefálico/métodos , Eletroencefalografia/métodos , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Córtex Motor/irrigação sanguínea , Córtex Motor/fisiopatologia , Convulsões/sangue , Convulsões/diagnóstico , Resultado do TratamentoRESUMO
Obtaining access to blood vessels can be difficult, especially in children. Visualization of subsurface blood vessels might be a solution. Ultrasound and visible light have been used to this purpose, but have some drawbacks. Near-infrared light might be a better option since subsurface blood vessels can be visualized in high contrast due to less absorption and scattering in tissue as compared to visible light. Our findings with a multispectral imaging system support this theory. A device, the VascuLuminator, was developed, based on transillumination of the puncture site with near-infrared light. The VascuLuminator was designed to meet the requirements of compact and safe use. A phantom study showed that the maximum depth of visibility (5.5mm for a 3.6mm blood vessel) is sufficient to visualize blood vessels in typical locations for peripheral venous and arterial access. A quantitative comparison of the VascuLuminator and to two other vessel imaging devices, using reflection of near-infrared light instead of transillumination, was conducted. The VascuLuminator is able to decrease failure at first attempt in blood withdrawal in pediatric patients from 10/80 (13%) to 1/45 (2%; P=.05).
Assuntos
Vasos Sanguíneos/anatomia & histologia , Raios Infravermelhos , Iluminação/instrumentação , Punções , Segurança , Coleta de Amostras Sanguíneas , Criança , Olho/efeitos da radiação , Humanos , Raios Infravermelhos/efeitos adversos , Iluminação/efeitos adversos , Pele/efeitos da radiaçãoRESUMO
INTRODUCTION: This study aims to evaluate for the first time the value of visualizing veins by a prototype of a near-infrared (NIR) vascular imaging system for venipuncture in children. METHODS: An observational feasibility study of venipunctures in children (0-6 years) attending the clinical laboratory of a pediatric university hospital during a period of 2 months without (n = 80) and subsequently during a period of 1 month with a prototype of an NIR vascular imaging system (n = 45) was conducted. Failure rate (ie, more than 1 puncture) and time of needle manipulation were determined. RESULTS: With the NIR vascular imaging system, failure rate decreased from 10/80 to 1/45 (P = .05) and time decreased from 2 seconds (1-10) to 1 second (1-4, P = .07). CONCLUSION: This study showed promising results on the value of an NIR vascular imaging system in facilitating venipunctures.
Assuntos
Coleta de Amostras Sanguíneas/métodos , Diagnóstico por Imagem/instrumentação , Raios Infravermelhos , Veias , Coleta de Amostras Sanguíneas/instrumentação , Criança , Pré-Escolar , Diagnóstico por Imagem/métodos , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , ObservaçãoRESUMO
OBJECTIVES: To determine the difference in light reflection of oral mucosa covering titanium (Ti) or zirconia (ZrO(2)) abutments as it relates to the thickness of the covering mucosa. MATERIAL AND METHODS: Fifteen anterior implants (Astra Osseo speed(®)) in 11 patients were fitted with a Ti or a ZrO(2) abutment (cross-over, within-subject comparison). Hyper-spectral images were taken with a camera fitted on a surgical microscope. High-resolution images with 70 nm interval between 440 and 720 nm were obtained within 30 s (1392 × 1024 pixels). Black- and white-point reference was used for spatial and spectral normalization as well as correction for motion during exposure. Reflection spectra were extracted from the image on a line mid-buccal of the implant, starting 1 mm above the soft tissue continuing up to 3 mm apically. RESULTS: Median soft tissue height is 2.3 mm (min: 1.2 mm and max: 3.1 mm). The buccal mucosa rapidly increases in the thickness, when moving apically. At 2.2 mm, thickness is 3 mm. No perceivable difference between the Ti and ZrO(2) abutment can be observed when the thickness of the mucosa is 2±0.1 mm (95% confidence interval) or more. CONCLUSION: It is expected that the difference in light reflection of soft tissue covering Ti or ZrO(2) abutments is no longer noticeable for the human eye when the mucosa thickness exceeds 2 mm. Haemoglobin peaks in the reflection spectrum can be observed and make hyper-spectral imaging a practical and useful tool for measuring soft tissue health.