Transcranial Ultrasound in the Helicopter Emergency Medical Services—A Feasibility Study

IF 2.5 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging Pub Date : 2026-08-18 DOI:10.1111/jon.70145

Ingrid N. Rognes, Pål C. W. Morberg, Henriette S. Jæger, Marius Rehn, Kristine Stø, Lars Alteheld, Else Charlotte Sandset, Maren R. Hov, Karianne Larsen

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引用次数: 0

Abstract

Background and Purpose

Transcranial color-coded Doppler (TCCD) is a noninvasive, widely available diagnostic method that may identify large vessel occlusion (LVO) in acute stroke patients. This study aimed to explore whether helicopter emergency medical services (HEMS) physicians could use TCCD in a prehospital setting to identify the proximal segment of the middle cerebral artery (M1-MCA).

Methods

In a feasibility study following brief training, three HEMS physicians and a single-reference examiner performed transtemporal TCCD examinations of four healthy volunteers, on ground and in flight a cruising helicopter. One color and one pulsed-wave Doppler image of M1-MCA were stored per examination, and time was recorded. TCCD images were retrospectively assessed by two raters for M1-MCA identification success and image quality, using a 5-point Likert scale.

Results

Participants performed a total of 32 bilateral M1-MCA examinations. The HEMS physicians identified M1-MCA in 83% of color Doppler examinations, with median (interquartile range [IQR]) time of 83 (63–130) s. Substantial inter-examiner variability was observed. The single-reference examiner identified M1-MCA in 88% of color Doppler examinations using 58 (49–101) s. Median (IQR) Likert scores for successful images were high: HEMS physicians 4.5 (4.5–5.0) and single-reference examiner 5.0 (4.5–5.0), with no significant difference between on-ground and in-flight examinations.

Conclusion

Following brief training, HEMS physicians were able to perform TCCD field examinations of M1-MCA in healthy volunteers, with identification rates and image quality comparable to a single-reference examiner. Substantial inter-examiner variability was observed, highlighting the importance of tailored training and competency assessment. Research is required to evaluate TCCD use by HEMS physicians under real-world prehospital conditions.

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经颅超声在直升机紧急医疗服务中的可行性研究

背景与目的经颅彩色编码多普勒（TCCD）是一种无创、广泛应用的诊断方法，可以识别急性脑卒中患者的大血管闭塞（LVO）。本研究旨在探讨直升机紧急医疗服务（HEMS）医生是否可以在院前使用TCCD识别大脑中动脉（M1-MCA）近段。方法在一项可行性研究中，三名HEMS医生和一名单一参考检查员对四名健康志愿者进行了经颞TCCD检查，分别在地面和巡航直升机上飞行。每次检查保存1张彩色和1张脉波多普勒图像，并记录时间。TCCD图像采用5分李克特量表，由两个评分者对M1-MCA识别成功和图像质量进行回顾性评估。结果参与者共进行了32次双侧M1-MCA检查。HEMS医生在83%的彩色多普勒检查中发现了M1-MCA，中位（四分位间距[IQR]）时间为83（63-130）秒。观察到大量的检查者之间的差异。使用58 (49-101)s的彩色多普勒检查，单参考检查者在88%的检查中发现了M1-MCA。成功图像的中位（IQR）李克特评分很高：HEMS医生4.5（4.5 - 5.0）和单参考检查者5.0(4.5 - 5.0)，在地面和飞行检查之间没有显著差异。结论经过简短的培训，HEMS医生能够对健康志愿者的M1-MCA进行TCCD现场检查，其识别率和图像质量与单一参考审查员相当。观察到大量的考官之间的差异，突出了量身定制的培训和能力评估的重要性。需要进行研究来评估HEMS医生在真实的院前条件下对TCCD的使用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neuroimaging 医学-核医学

CiteScore

4.70

自引率

0.00%

发文量

117

审稿时长

6-12 weeks

期刊介绍： Start reading the Journal of Neuroimaging to learn the latest neurological imaging techniques. The peer-reviewed research is written in a practical clinical context, giving you the information you need on: MRI CT Carotid Ultrasound and TCD SPECT PET Endovascular Surgical Neuroradiology Functional MRI Xenon CT and other new and upcoming neuroscientific modalities.The Journal of Neuroimaging addresses the full spectrum of human nervous system disease, including stroke, neoplasia, degenerating and demyelinating disease, epilepsy, tumors, lesions, infectious disease, cerebral vascular arterial diseases, toxic-metabolic disease, psychoses, dementias, heredo-familial disease, and trauma.Offering original research, review articles, case reports, neuroimaging CPCs, and evaluations of instruments and technology relevant to the nervous system, the Journal of Neuroimaging focuses on useful clinical developments and applications, tested techniques and interpretations, patient care, diagnostics, and therapeutics. Start reading today!