Acoustocerebrography (ACG) is a medical test used to diagnose changes and problems in the brain and the central nervous system.[1] It allows for the noninvasive examination of the brain's cellular and molecular structure. It can also be applied as a means to diagnose and monitor intracranial pressure, for example as incorporated into continuous brain monitoring devices. ACG uses molecular acoustics,[2] in audible and ultrasound frequency ranges, to monitor changes. It may use microphones, accelerometers, and multifrequency ultrasonic transducers. It does not use any radiation and is completely free of any side effects. ACG also facilitates blood flow analysis as well as the detection of obstructions in cerebral blood flow (from cerebral embolism) or bleeding (from cerebral hemorrhage).
Passive and active acoustocerebrography
editPassive acoustocerebrography
editAll brain tissue is influenced by blood circulating in the brain's vascular system. With each heartbeat, blood circulates in the skull, following a recurring pattern according to the oscillation produced. This oscillation's effect, in turn, depends on the brain's size, form, structure and its vascular system. Thus, every heartbeat stimulates minuscule motion in the brain tissue as well as cerebrospinal fluid and therefore produces minimal changes in intracranial pressure. These changes can be monitored and measured in the skull. Today, mostly passive sensors like accelerometers are used to identify these signals correctly.[3] Sometimes highly sensitive microphones are utilized. [4][5][6]
With a digital signal, it becomes possible to study the patterns of the blood flow moving inside the skull. These patterns form unique signatures that can be analyzed with specially designed algorithms, identifying them either as an inconspicuous, “normal” pattern or as a pattern showing an “abnormal” behavior.
Active acoustocerebrography
editIn active ACG applications, a multi-frequency ultrasonic signal is used to detect and classify adverse changes at the cellular or molecular level.[7] In addition to all of the advantages that passive ACG provides, with active ACG it is possible to conduct a spectral analysis of the acoustic signals received. These spectrum analyses not only display changes in the brain's vascular system, but also those in its cellular and molecular structures. One common application of active ACG is the Transcranial Doppler test. More recently, its color version (TCCD) has been deployed. These ultrasonic procedures measure blood flow velocity within the brain's blood vessels. They are used to diagnose embolisms, stenoses and vascular constrictions, for example, in the aftermath of a subarachnoid hemorrhage.
Fields of application
editIn contrast with applications that provide only momentary images, such as MRI and CT, the results of ACG procedures can be obtained continuously, thus facilitating effortless and non-invasive real-time monitoring. This can be especially helpful during the acute phase directly after a stroke or a traumatic brain injury. The measured data is mathematically processed continuously and displayed on a monitoring device. The computer-aided analysis of the signals enables the physician/nursing staff to precisely interpret the results immediately after device setup. Furthermore, ACG allows for preventive detection of pathological changes in brain tissue.
References
edit- ^ Bogdan, Martin; Kolany, Adam; Weber, Ulrike; Elze, Romy; Wrobel, Miroslaw (2016). "Computer Aided Multispectral Ultrasound Diagnostics Brain Health Monitoring System Based on Acoustocerebrography". XIV Mediterranean Conference on Medical and Biological Engineering and Computing 2016. IFMBE Proceedings. Vol. 57. pp. 983–987. doi:10.1007/978-3-319-32703-7_192. ISBN 978-3-319-32701-3.
- ^ Molekularakustik - Eine Einführung in die Zusammenhänge zwischen Ultraschall und Molekülstruktur in Flüssigkeiten und Gasen, Werner Schaaffs (1963)
- ^ Smith, Wade S.; Browne, Janet L.; Ko, Nerissa U. (2015). "Cranial Accelerometry Can Detect Cerebral Vasospasm Caused by Subarachnoid Hemorrhage". Neurocritical Care. 23 (3): 364–369. doi:10.1007/s12028-015-0118-9. PMID 25761424.
- ^ Sun, M; Sekhar, LN; Sclabassi, RJ; Wasserman, JF; Blue, HB; Luyckx, KA (1988). "Recording and processing aneurysmal vibration signals in dogs". J Biomed Eng. 10 (4): 336–42. doi:10.1016/0141-5425(88)90064-7. PMID 3070164.
- ^ Sekhar, L N; Sun, M; Bonaddio, D; Sclabassi, R J (1990). "Acoustic recordings from experimental saccular aneurysms in dogs". Stroke. 21 (8): 1215–1221. doi:10.1161/01.STR.21.8.1215. ISSN 0039-2499. PMID 2389303.
- ^ Kosugi, Yukio; Ikebe, Jun; Hara, Shoji; Takakura, Kintomo (1987). "Detection and Analysis of Cranial Bruit". IEEE Transactions on Biomedical Engineering (3): 185–191. doi:10.1109/TBME.1987.325943.
- ^ Wrobel, Miroslaw; Dabrowski, Andrzej; Kolany, Adam; Olak-Popko, Anna; Olszewski, Robert; Karlowicz, Pawel (2016). "On ultrasound classification of stroke risk factors from randomly chosen respondents using non-invasive multispectral ultrasonic brain measurements and adaptive profiles". Biocybernetics and Biomedical Engineering. 36: 19–28. doi:10.1016/j.bbe.2015.10.004.