多模态MRI在终末期肾病合并认知障碍中的研究进展

Progress of multimodal MRI in end-stage renal disease complicated with cognitive impairment

认知障碍在终末期肾病(end-stage renal disease, ESRD)患者中非常普遍,这种障碍涉及一系列认知领域,包括注意力、记忆力和执行力等,严重降低了患者的生活质量。然而这种神经认知缺陷的确切机制尚不清楚,因此在早期阶段检测和管理这种认知障碍具有很大的挑战性。近年来多模态磁共振成像在这一领域取得了诸多成果,并有望选择出指导早期筛查及诊断慢性肾脏疾病(chronic kidney disease, CKD)患者认知缺陷的影像学生物标志物。本文将简要阐述多种MRI新兴技术及人工智能在ESRD合并认知障碍患者中的研究进展,尝试揭示ESRD患者脑结构、功能、灌注、代谢及神经血管耦合与认知功能障碍之间的联系,帮助临床了解ESRD患者大脑缺陷的潜在神经元机制,有利于合并认知障碍ESRD患者的早期诊断、治疗及随访。

Cognitive impairment is highly prevalent in patients with end-stage renal disease,and this impairment,which involves a range of cognitive domains including attention,memory,and executive functioning,severely diminishes patients'quality of life.However,the exact mechanisms underlying this neurocognitive deficit are unknown,making it challenging to detect and manage this cognitive impairment at an early stage.Multimodal magnetic resonance imaging has yielded many results in this area in recent years and holds the promise of selecting imaging biomarkers to guide early screening and diagnosis of cognitive deficits in patients with chronic kidney disease(CKD).This paper will briefly describe the research progress of various emerging MRI technologies and artificial intelligence in end-stage renal disease(ESRD)patients with cognitive impairment,and try to reveal the connection between brain structure,function,perfusion,metabolism,neurovascular coupling and cognitive dysfunction in ESRD patients,so as to help clinical understanding of the potential neuronal mechanism of brain defects in ESRD patients.It is beneficial to the early diagnosis,treatment and follow-up of ESRD patients with cognitive impairment.