动脉瘤蛛网膜下腔出血术后认知功能障碍患者的脑结构及功能的MRI研究进展

MRI research progress of brain structure and function in patients with cognitive dysfunction after aneurysmal subarachnoid hemorrhage

动脉瘤蛛网膜下腔出血(aneurysmal subarachnoid hemorrhage,aSAH)在年轻人中常见,致残致死率高,且超过50%的患者术后会出现认知功能障碍,表现在多个领域:语言、记忆、视觉感知能力、信息处理、注意力以及执行功能,严重影响患者的生存质量,给患者、家庭及社会带来沉重的精神和经济负担。早期诊断和治疗有助于患者的功能恢复和生活质量的提高,但其诊断需要一系列神经认知量表的评估,耗时且具有主观性。MRI具有无创、无辐射的优势,应用不同的颅脑影像序列(3D T1WI、扩散张量成像、功能MRI)能够从不同角度获取脑微观结构和功能的改变,为aSAH患者术后认知功能障碍的早期诊断、疾病监测、预后评估及病理机制提供影像学的独特见解。本研究对aSAH患者术后认知功能障碍的脑结构及功能MRI研究进展进行综述,旨在探索aSAH早期诊断、患者术后认知功能障碍评估的相关MRI参数,以期有益于早期治疗及改善预后。

Aneurysmal subarachnoid hemorrhage(aSAH)is common in young people with high disability and mortality,and over half of the patients have cognitive dysfunction after surgery.Cognitive dysfunction after aSAH is manifested in a variety of areas:language,memory,visual perception,information processing,attention,and executive function.It seriously affects the quality of life of patients,and brings heavy spiritual and economic burden to patients,families and society.Early diagnosis and treatment can help patients recover function and improve quality of life.But its diagnosis requires assessment on a series of neurocognitive scales,which is time-consuming and subjective.MRI is non-invasive and non-radiative.Different cranial imaging techniques including 3D T1WI,diffusion tensor imaging and function MRI applied to patients,we can obtain changes of brain microstructure and function from different perspectives,which offer unique insight into early diagnosis,disease monitoring,prognosis assessment and pathological mechanism of postoperative cognitive dysfunction in aSAH patients.This study aims to explore the MRI parameters related to the early diagnosis of aSAH and the assessment of postoperative cognitive dysfunction by reviewing the research progress of brain structural and functional MRI neuroimaging in patients with cognitive dysfunction afeter aSAH,so as to be beneficial to early treatment and improve prognosis.