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神经放射学概述。

Overview of neuroradiology.

作者信息

Larsson Elna-Marie, Wikström Johan

机构信息

Section of Neuroradiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.

Section of Neuroradiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.

出版信息

Handb Clin Neurol. 2017;145:579-599. doi: 10.1016/B978-0-12-802395-2.00037-7.

Abstract

Neuroradiology with computed tomography (CT) and magnetic resonance imaging (MRI) is essential for the initial evaluation of patients with a clinical suspicion of brain and spine disorders. Morphologic imaging is required to obtain a probable diagnosis to support the treatment decisions in pre- and perinatal disorders, vascular diseases, traumatic injuries, metabolic disorders, epilepsy, infection/inflammation, neurodegenerative disorders, degenerative spinal disease, and tumors of the central nervous system. Different postprocessing tools are increasingly used for three-dimensional visualization and quantification of lesions. Additional information is provided by angiographic methods and physiologic CT and MRI techniques, such as diffusion MRI, perfusion CT/MRI, MR spectroscopy, functional MRI, tractography, and nuclear medicine imaging methods. Positron emission tomography (PET) is now integrated with CT (PET/CT), and PET/MR scanners have recently also been introduced. These hybrid techniques facilitate the co-registration of lesions with different modalities, and give new possibilites for functional imaging. Repeated imaging is increasingly performed for treatment monitoring. The improved imaging techniques together with the neuropathologic diagnosis after biopsy or surgery allow more personalized treatment of the patient. Neuroradiology also includes endovascular treatment of aneurysms and arteriovenous malformations as well as thrombectomy in acute stroke. This catheter-based treatment has replaced invasive neurosurgery in many cases.

摘要

对于临床怀疑患有脑和脊柱疾病的患者,计算机断层扫描(CT)和磁共振成像(MRI)的神经放射学检查对于初始评估至关重要。形态学成像对于获得可能的诊断以支持围产期疾病、血管疾病、创伤性损伤、代谢紊乱、癫痫、感染/炎症、神经退行性疾病、退行性脊柱疾病以及中枢神经系统肿瘤的治疗决策是必需的。不同的后处理工具越来越多地用于病变的三维可视化和量化。血管造影方法以及生理CT和MRI技术,如扩散MRI、灌注CT/MRI、磁共振波谱、功能MRI、纤维束成像和核医学成像方法,可提供额外信息。正电子发射断层扫描(PET)现在已与CT整合(PET/CT),最近还引入了PET/MR扫描仪。这些混合技术有助于不同模态下病变的配准,并为功能成像提供了新的可能性。越来越多地进行重复成像以监测治疗。改进的成像技术以及活检或手术后的神经病理学诊断使患者能够接受更个性化的治疗。神经放射学还包括动脉瘤和动静脉畸形的血管内治疗以及急性卒中的血栓切除术。这种基于导管的治疗在许多情况下已取代了侵入性神经外科手术。

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