近红外光谱成像在脑血管病诊疗中的应用价值

The Application of Near Infrared Spectroscopy in Diagnosis and Treatment of Cerebrovascular Diseases

对脑血管病患者的脑组织氧合情况实施床旁监测,对脑血管病的诊治及预后改善有重要价值。近红外光谱成像(near infrared spectroscopy,NIRS)作为一项新兴的脑成像技术,具有价格低廉、操作便捷、非侵入性等优点,逐渐成为脑血管病研究的焦点。本文介绍了NIRS的基本原理,探讨了NIRS在急性脑梗死早期识别、梗死后再灌注疗效评估、大面积脑梗死继发恶性脑水肿预测等方面的应用价值,预测了NIRS在大脑近皮层出血病情监测中的应用前景。此外,在蛛网膜下腔出血诊疗领域,NIRS通过动态监测脑氧饱和度,在迟发性脑缺血监测及术后功能结局预测等方面也有着较大的应用潜力。最后,本文基于NIRS的优势和不足,展望了未来适合NIRS应用的临床场景。加强NIRS在脑血管病领域的研究,将使实时评估脑血管病院前、院内的精准动态成为可能。

Bedside monitoring of cerebral oxygenation in patients with cerebrovascular diseases is of great value for the diagnosis,treatment and prognosis of cerebrovascular diseases.As a novel brain imaging technology,near infrared spectroscopy(NIRS)has the advantages of low price,good convenience and non-invasiveness.It has gradually become the focus of cerebrovascular disease research.This article introduced the basic principle of NIRS,the application of NIRS in early recognition of acute cerebral infarction,efficacy evaluation of reperfusion after infarction,and prediction of malignant cerebral edema secondary to large cerebral infarction,and also the application prospect of NIRS in monitoring the hemorrhage near cerebral cortex.For patients with subarachnoid hemorrhage,NIRS may play a great potential role in monitoring delayed cerebral ischemia and predicting postoperative functional outcome by dynamical monitoring cerebral oxygen saturation.Finally,based on the advantages and disadvantages of NIRS,we looked forward to the clinical scenarios suitable for NIRS application in the future.Further NIRS research in cerebrovascular disease will make accurate pre-hospital and in-hospital real-time dynamic assessment of cerebrovascular disease possible.