IMAGING BRAIN INJURY USING TIME-RESOLVED NEAR-INFRARED LIGHT SCANNING

Conventional brain imaging modalities are limited in that they image o nly secondary physical manifestations of brain injury, which may occur well after the actual insult to the brain and represent irreversible structural changes, A real-time continuous bedside monitor that images functional changes in cerebral blood flow or oxygenation might allow for recognition of brain tissue ischemia or hypoxia before the develop ment of irreversible injury. Visible and near infrared light pass thro ugh human bone and tissue in small amounts, and the emerging light can be used to form images of the interior structure of the tissue and me asure tissue blood flow and oxygen utilization based on light absorban ce and scattering. We developed a portable time-of-flight and absorban ce system which emits pulses of near infrared light into tissue and me asures the transit time of photons through the tissue. Images can then be reconstructed mathematically using either absorbance or scattering information. Pathologic brain specimens from adult sheep and human ne wborns were studied with this device using rotational optical tomograp hy. Images generated from these optical scans show that neonatal brain injuries such as subependymal and intraventricular hemorrhages can be successfully identified and localized. Resolution of this system appe ars to be better than 1 cm at a tissue depth of 5 cm, which should be sufficient for imaging some brain lesions as well as for detection of regional changes in cerebral blood flow and oxygenation. We conclude t hat light-based imaging of cerebral structure and function is feasible and may permit identification of patients with impending brain injury as well as monitoring of the efficacy of intervention. Construction o f real-time images of brain structure and function is now underway usi ng a fiber optic headband and nonmechanical rotational scanner allowin g comfortable, unintrusive monitoring over extended periods of time.