多模态磁共振成像诊断创伤半暗带的研究进展

Progress of multimodality magnetic resonance imaging in diagnosing penumbra of trauma

创伤半暗带是存在于创伤性脑损伤后损伤核心区外周的一可挽回区域,是影响脑损伤患者预后和后期生活质量的一个重要因素。临床通过早期诊断、及时治疗创伤半暗带,可有效阻止其内的脑组织向有害方向发展,从而达到降低创伤性脑损伤所致的高致残率。多模态磁共振成像技术是一种广泛应用于颅脑疾病诊断的手段,具有分辨率高、精确度高、无侵袭性等优点。利用多模态磁共振技术(弥散加权成像、脑灌注成像、动脉自旋标记成像、磁敏感加权成像及磁共振波谱)能了解创伤半暗带的存在、范围以及其内的物质与能量代谢情况等,为临床选择治疗方案及评估疗效与预后提供客观的影像学依据。随着多模态磁共振技术的发展,界定创伤半暗带的磁共振方法也出现了多样化。本文主要就创伤半暗带与脑损伤病理生理机制、多模态磁共振成像序列、多模态磁共振成像评估创伤半暗带等方面进行综述。

Traumatic penumbra is a reversible area present in the periphery of the injured core area after traumatic brain injury.It is an important factor affecting the prognosis and later quality of life of patients with brain injury. Through early diagnosis and timely treatment of traumatic penumbra, the brain tissue in it can be effectively prevented from developing in a harmful direction, so as to reduce the high disability rate caused by traumatic brain injury. Multimodal magnetic resonance imaging is widely used in the diagnosis of brain diseases, which has the advantages of high resolution, high accuracy and noninvasiveness. Multimodality magnetic resonance technology(diffusion weighted imaging, cerebral perfusion imaging, arterial spin labeling, susceptibility-weighted imaging and magnetic resonance spectroscopy) can be used to understand the presence and extent of traumatic penumbra and its substance and energy metabolism, providing an objective imaging basis for clinical treatment selection and evaluation of curative effect and prognosis. In recent years, with the development of multi-modal magnetic resonance technology, the magnetic resonance methods to define the traumatic penumbra have also been diversified.This review focuses on the pathophysiological mechanisms of traumatic penumbra and brain injury, multimodality magnetic resonance imaging sequences, and multimodality magnetic resonance imaging to assess traumatic penumbra.