影像学在动脉瘤性蛛网膜下腔出血预后中的应用进展

Progress in Application of Imaging in Prognosis of Aneurysm Subarachnoid Hemorrhage

动脉瘤性蛛网膜下腔出血(a SAH)是最常见的非创伤性蛛网膜下腔出血,是世界范围内死亡和致残的主要原因。大多数幸存者患有严重的神经功能及认知功能障碍,严重丧失工作及生活能力。目前,临床上常利用世界神经外科医师联盟量表、Fisher评分、改良Fisher评分等量表评估a SAH的严重程度和预后。由于a SAH后损伤的病理生理机制非常复杂,早期预测血管痉挛和迟发性脑缺血等并发症以及a SAH的临床预后具有挑战性,影像学在a SAH患者的早期评估中起重要作用,其中包括CT、经颅多普勒超声、CT灌注成像、磁共振成像等,并且在评估并发症和预后方面显得越来越重要。

Aneurysm subarachnoid hemorrhage(a SAH) is the most common non-traumatic subarachnoid hemorrhage and a main cause of death and disability in the world.Most survivors suffer from severe neurological and cognitive impairment and severe loss of work and living ability.At present,the World Federation of Neurosurgeons scale,Fisher score and modified Fisher score are often used to evaluate the severity and prognosis of a SAH.Because the pathophysiological mechanism of post-aSAH injury is very complex,it is challenging to predict the complications such as vasospasm and delayed cerebral ischemia early,as well as the clinical prognosis of a SAH.Imaging plays an important role in the early evaluation of a SAH patients,including CT,transcranial Doppler,CT perfusion imaging,magnetic resonance imaging and so on,and is becoming more and more important in evaluating the complications and prognosis.