IRCCS Centro Neurolesi Bonino-Pulejo, Messina, Italy.
Neurocrit Care. 2011 Feb;14(1):127-33. doi: 10.1007/s12028-010-9406-6.
Traumatic brain injury (TBI) is a common cause of neurological damage and disability. Conventional imaging (CT scan or MRI) is highly sensitive in detecting lesions and provides important clinical information regarding the need for acute intervention. However, abnormalities detected by CT scan or conventional MRI have limited importance in the classification of the degree of clinical severity and in predicting patients' outcome. This can be explained by the widespread microscopic tissue damage occurring after trauma, which is not observable with the conventional structural imaging methods. Advances in neuroimaging over the past two decades have greatly helped in the clinical care and management of patients with TBI. The advent of newer and more sensitive imaging techniques is now being used to better characterize the nature and evolution of injury and the underlying mechanisms that lead to progressive neurodegeneration, recovery or subsequent plasticity. This review will describe the role of proton magnetic resonance spectroscopic (MRS), an advanced MRI technique as related to its use in TBI. Proton MRS is a noninvasive approach that acquires metabolite information reflecting neuronal integrity and function from multiple brain regions and allows to assess clinical severity and to predict disease outcome.
创伤性脑损伤（TBI）是神经损伤和残疾的常见原因。传统影像学（CT 扫描或 MRI）在检测病变方面非常敏感，并提供有关急性干预必要性的重要临床信息。然而，CT 扫描或常规 MRI 检测到的异常在临床严重程度的分类和预测患者预后方面意义有限。这可以解释为创伤后广泛发生的微观组织损伤，这是常规结构成像方法无法观察到的。过去二十年中神经影像学的进步极大地帮助了 TBI 患者的临床护理和管理。现在，新的、更敏感的成像技术的出现，用于更好地描述损伤的性质和演变以及导致进行性神经退行性变、恢复或随后的可塑性的潜在机制。本综述将描述质子磁共振波谱（MRS）作为一种先进的 MRI 技术在 TBI 中的作用。质子 MRS 是一种非侵入性方法，可从多个脑区获取反映神经元完整性和功能的代谢物信息，并可评估临床严重程度和预测疾病预后。
