Application value of electrical impedance tomography in assessment of patients with brain injury

doi:10.16352/j.issn.1001-6325.2024.11.1499

Abstract

Abstract: Electrical impedance tomography (EIT) estimates the spatial distribution of tissue electrical properties by measuring the transfer impedance between surface electrodes. which has shown great potential in medical imaging, especially in the evaluation of brain injury patients. This review introduces the application of EIT in the evaluation of brain injury patients, including diagnosis and monitoring of stroke, cerebral edema, and epileptic foci. In stroke research, consecutive and real-time EIT monitoring may support early diagnosis of intracranial lesions, identification of stroke types, and improvement of prognosis. For cerebral edema, EIT can monitor intracranial pressure in real-time and evaluate the effectiveness of dehydration treatment. EIT is used for lesion localization and seizure monitoring. The review also summarizes the existing problems of EIT and technical challenges that may orient future research as well as clinical application.

Key words: electrical impedance tomography (EIT), brain injury, tissue impedance

CLC Number:

R563

NING Yachan, YAN Bin, LIU Bo, WANG Chunmei. Application value of electrical impedance tomography in assessment of patients with brain injury[J]. Basic & Clinical Medicine, 2024, 44(11): 1499-1503.

References

[1] Ke X, Hou W, Huang Q, et al. Advances in electrical impedance tomography-based brain imaging[J]. Mil Med Res, 2022,9:705-726. doi:10.1186/s40779-022-00370-7.
[2] Rauseo M, Spinelli E, Sella N, et al. Expert opinion document: “Electrical impedance tomography: applications from the intensive care unit and beyond”[J]. Anesth Analg Crit Care, 2022,2:28. doi:10.1186/s44158-022-00055-6.
[3] Witkowska-Wrobel A, Aristovich K, Faulkner M, et al. Feasibility of imaging epileptic seizure onset with EIT and depthelectrodes[J].NeuroImage,2018,173:311-321.doi:10.1016/j.neuroimage.2018.02.056.
[4] Kafkas N, Liakos C, Zoubouloglou F, et al. Neutrophil gelatinase-associated lipocalin as an early marker of contrast-induced nephropathy after elective invasive cardiac procedures[J]. Clin Cardiol, 2016,39:464-470. doi:10.1002/clc.22551.
[5] Yang B, Li B, Xu C, et al. Comparison of electrical impedance tomography and intracranial pressure during dehydration treatment of cerebral edema[J].Neuroimage-Clin,2019,23:101909. doi:10.1016/j.nicl.2019.101909.
[6] Murai T, Kagawa Y. Electrical impedance computed tomography based on a finite element model[J].IEEE T Bio-med Eng,1985,32:177-184. doi:10.1109/TBME.1985.325526.
[7] Pettigrew RI, Peterson KP, Heetderks W, et al. The National Institute of Biomedical Imaging and Bioengineering marks its first five years[J]. Acad Radiol, 2007,14:1448-1454. doi:10.1016/j.acra.2007.10.004.
[8] Halter RJ, Hartov A, Paulsen KD. A broadband high-frequency electrical impedance tomography system for breast imaging[J]. IEEE T Biomed Eng, 2008,55:650-659. doi:10.1109/TBME.2007.903516.
[9] Zhao Z, Chang M, Chang M, et al. Positive end-expiratory pressure titration with electrical impedance tomography and pressure-volume curve in severe acute respiratory distress syndrome[J]. Ann Intensive Care, 2019,9:7. doi:10.1186/s13613-019-0484-0.
[10] Cao L, Li H, Fu D, et al. Real-time imaging of infarction deterioration after ischemic stroke in rats using electrical impedance tomography[J]. Physiol Meas, 2020,41:15004. doi:10.1088/1361-6579/ab69ba.
[11] Gilad O, Holder DS. Impedance changes recorded with scalp electrodes during visual evoked responses: implications for electrical impedance tomography of fast neural activity[J]. NeuroImage, 2009,47:514-522. doi:10.1016/j.neuroimage.2009.04.085.
[12] Tidswell AT, Gibson A, Bayford RH, et al. Electrical impedance tomography of human brain activity with a two-dimensional ring of scalp electrodes[J]. Physiol Meas,2001,22:167-175. doi:10.1088/0967-3334/22/1/320.
[13] Gilad O, Ghosh A, Oh D, et al. A method for recording resistance changes non-invasively during neuronal depolarization with a view to imaging brain activity with electrical impedance tomography[J]. J Neurosci Meth, 2009,180:87-96. doi:10.1016/j.jneumeth.2009.03.012.
[14] Tang T, Oh S, Sadleir RJ. A robust current pattern for the detection of intraventricular hemorrhage in neonates using electrical impedance tomography[J]. Ann Bio Eng, 2010,38(8):2733-2747. doi:10.1007/s10439-010-0003-9.
[15] 36th International Symposium on Intensive Care and Emergency Medicine: Brussels, Belgium. 15-18 March 2016[J]. Critical care (London, England), 2016,20(Suppl 2):94. doi:10.1186/s13054-016-1208-6.
[16] Lingwood BE, Dunster KR, Healy GN, et al. Cerebral impedance and neurological outcome following a mild or severe hypoxic/ischemic episode in neonatal piglets[J]. Brain Res, 2003,969:160-167. doi:10.1016/s0006-8993(03)02295-9.
[17] Campbell BCV, Khatri P. Stroke[J].Lancet,2020,396:129-142. doi: 10.1016/S0140-6736(20)31179-X.
[18] Hacke W, Kaste M, Bluhmki E, et al. Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke[J]. N Engl J Med, 2008,359:1317-1329. doi:10.1056/NEJMoa0804656.
[19] Yang L, Xu C, Dai M, et al. A novel multi-frequency electrical impedance tomography spectral imaging algorithm for early stroke detection[J]. Physiol Meas, 2016,37:2317-2335. doi:10.1088/1361-6579/37/12/2317.
[20] Seo JK, Lee J, Kim SW, et al. Frequency-difference electrical impedance tomography (fdEIT): algorithm development and feasibility study[J]. Physiol Meas, 2008,29:929-944. doi:10.1088/0967-3334/29/8/006.
[21] Romsauerova A, McEwan A, Holder DS. Identification of a suitable current waveform for acute stroke imaging[J]. Physiol Meas, 2006,27:S211-S219. doi:10.1088/0967-3334/27/5/S18.
[22] Malone E, Jehl M, Arridge S, et al. Stroke type differentiation using spectrally constrained multifrequency EIT: evaluation of feasibility in a realistic head model[J]. Physiol Meas, 2014,35:1051-1066. doi:10.1088/0967-3334/35/6/1051.
[23] Malone E, Santos GSD, Holder D, et al. Multifrequency electrical impedance tomography using spectral constraints[J]. IEEE T Med Imaging,2014,33:340-350. doi:10.1109/TMI.2013.2284966.
[24] Dowrick T, Blochet C, Holder D. In vivo bioimpedance changes during haemorrhagic and ischaemic stroke in rats: towards 3D stroke imaging using electrical impedance tomography[J]. Physiol Meas, 2016,37:765-784. doi:10.1088/0967-3334/37/6/765.
[25] Dai M, Li B, Hu S, et al. In vivo imaging of twist drill drainage for subdural hematoma: a clinical feasibility study on electrical impedance tomography for measuring intracranial bleeding in humans[J]. PLoS One, 2013,8:e55020. doi:10.1371/journal.pone.0055020.
[26] 王立伟, 杨晨, 吴冠, 等. 脑阻抗断层扫描在Stanford A型主动脉夹层术后脑卒中诊断中的应用[J]. 空军军医大学学报, 2023,44:739-743.
[27] Hannan S, Faulkner M, Aristovich K, et al. Imaging fast electrical activity in the brain during ictal epileptiform discharges with electrical impedance tomography[J].Neuro Image Clin,2018,20:674-684. doi:10.1016/j.nicl.2018.09.004.
[28] Vongerichten AN, Santos GSD, Aristovich K, et al. Characterisation and imaging of cortical impedance changes during interictal and ictal activity in the anaesthetised rat[J]. Neuro Image, 2016,124:813-823. doi:10.1016/j.neuroimage.2015.09.015.
[29] Fabrizi L, Sparkes M, Horesh L, et al. Factors limiting the application of electrical impedance tomography for identification of regional conductivity changes using scalp electrodes during epileptic seizures in humans[J]. Physiol Meas, 2006,27:S163-S174. doi:10.1088/0967-3334/27/5/S14.
[30] Xu M, Long K, Jian Z, et al. Nonlinear analysis on the EEG information of rat epileptic model[J]. J Biomedical Eng,2003,20:511-514.
[31] Wang L, Sun Y, Xu X, et al. Real-time imaging of epileptic seizures in rats using electrical impedance tomography[J]. Neuroreport, 2017,28:689-693. doi:10.1097/WNR.0000000000000823.
[32] Fu F, Li B, Dai M, et al. Use of electrical impedance tomography to monitor regional cerebral edema during clinical dehydration treatment[J]. PLoS One, 2014,9:e113202. doi:10.1371/journal.pone.0113202.
[33] Song J, Chen R, Yang L, et al. Electrical impedance changes at different phases of cerebral edema in rats with ischemic brain injury[J].Bio Med Res Int,2018,2018:9765174. doi:10.1155/2018/9765174.
[34] Manwaring PK, Moodie KL, Hartov A, et al. Intracr-anial electrical impedance tomography: a method of continuous monitoring in an animal model of head trauma[J]. Anesth Analg, 2013,117:866-875. doi:10.1213/ANE.0b013e318290c7b7.