Cabanis Emmanuel Alain, Iba-Zizen Marie-Thérèse, Habas Christophe, Istoc Adrian, Stievenart Jean-Louis, Yoshida Masaki, Nguyen Thien Huong, Goepel Roland
Académie nationale de médecine.
Bull Acad Natl Med. 2009 Apr;193(4):837-47.
Brain imaging has progressed over the centuries, from prehistory (surgical and sculptural empiricism), through the Middle Ages (dissection and drawings), the Renaissance (printing) and the 18th century (Spallanzani and ultrasounds), to the 19th century and the discovery of piezoelectricity by the Curie brothers and X-rays by Röntgen in 1895. The head had finally become transparent! The microscope was used by Ramon Y Cajal for histological and neuropathological brain studies. Marie Curie's discovery of radioisotopes paved the way for advances in in vivo neurophysiology. In the 20th century, technical progress accelerated with the advent of computed tomography. Injected contrast products were initially negative (air for ventriculography and pneumo-encephalography), and subsequently positive (intraventricular then intraarterial iodine, cerebral arteriography, increasingly hyperselective). Neurology and neurosurgery were followed by neuroradiology, stereotaxy, and interventional neuroradiology. G.N. Hounsfield's EMI CT scanner replaced silver salts crystals with computed pixels and voxels. Magnetic resonance imaging (MRI, 1981), which dispenses with the need for X-rays, is evolving at the same pace as computer science itself (Moore's Law) in the form of nanometric biophotonics for example. Diffusion MRI is providing precious information on neuroanatomy (axonal organization of the white matter and neuro-tractography, vascular anatomy), neurochemistry (MRS) and neurophysiology. Functional MRI of sensory activation and resting connectivity, the substrate of thought, is giving fascinating results. Functional stereotactic neurosurgery (for epilepsy, abnormal movements, etc.), stereotactic radiosurgery and endovascular interventional neuroradiology are among the latest approaches.
几个世纪以来,脑成像技术不断发展,从史前时期(外科手术和雕塑经验主义),历经中世纪(解剖学和绘图)、文艺复兴时期(印刷术)以及18世纪(斯帕兰扎尼和超声波),直至19世纪居里兄弟发现压电效应以及1895年伦琴发现X射线。头部终于变得“透明”了!拉蒙·伊·卡哈尔使用显微镜进行脑组织学和神经病理学研究。玛丽·居里发现放射性同位素为体内神经生理学的进步铺平了道路。在20世纪,随着计算机断层扫描技术的出现,技术进步加速。最初使用的注射造影剂是阴性的(脑室造影和气脑造影用空气),随后是阳性的(脑室内然后脑动脉内注射碘,脑血管造影,选择性越来越高)。继神经病学和神经外科之后出现了神经放射学、立体定向技术和介入神经放射学。G.N.亨斯菲尔德的EMI计算机断层扫描仪用计算像素和体素取代了银盐晶体。无需X射线的磁共振成像(MRI,1981年)正以与计算机科学本身(摩尔定律)相同的速度发展(例如以纳米生物光子学的形式)。扩散磁共振成像正在提供有关神经解剖学(白质的轴突组织和神经纤维束成像、血管解剖学)、神经化学(磁共振波谱)和神经生理学的宝贵信息。感觉激活和静息连接的功能磁共振成像作为思维基础,正产生令人着迷的结果。功能性立体定向神经外科手术(用于治疗癫痫、异常运动等)、立体定向放射外科手术和血管内介入神经放射学是最新的治疗方法。