1 Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of University Southern California, Marina del Rey, CA, USA.
2 Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA.
Neuroscientist. 2018 Dec;24(6):652-670. doi: 10.1177/1073858418759489. Epub 2018 Feb 28.
Traumatic brain injury (TBI) is a significant public health problem in the United States, especially for children and adolescents. Current epidemiological data estimate over 600,000 patients younger than 20 years are treated for TBI in emergency rooms annually. While many patients experience a full recovery, for others there can be long-lasting cognitive, neurological, psychological, and behavioral disruptions. TBI in youth can disrupt ongoing brain development and create added family stress during a formative period. The neuroimaging methods used to assess brain injury improve each year, providing researchers a more detailed characterization of the injury and recovery process. In this review, we cover current imaging methods used to quantify brain disruption post-injury, including structural magnetic resonance imaging (MRI), diffusion MRI, functional MRI, resting state fMRI, and magnetic resonance spectroscopy (MRS), with brief coverage of other methods, including electroencephalography (EEG), single-photon emission computed tomography (SPECT), and positron emission tomography (PET). We include studies focusing on pediatric moderate-severe TBI from 2 months post-injury and beyond. While the morbidity of pediatric TBI is considerable, continuing advances in imaging methods have the potential to identify new treatment targets that can lead to significant improvements in outcome.
创伤性脑损伤（TBI）是美国一个重大的公共卫生问题，特别是对儿童和青少年而言。目前的流行病学数据估计，每年有超过 60 万名 20 岁以下的患者在急诊室接受 TBI 治疗。虽然许多患者完全康复，但对于其他患者而言，可能会出现长期的认知、神经、心理和行为障碍。青少年时期的 TBI 会破坏正在进行的大脑发育，并在形成期给家庭带来额外的压力。用于评估脑损伤的神经影像学方法每年都在改进，为研究人员提供了对损伤和恢复过程更详细的描述。在这篇综述中，我们涵盖了目前用于量化损伤后大脑破坏的成像方法，包括结构磁共振成像（MRI）、扩散 MRI、功能 MRI、静息态 fMRI 和磁共振波谱（MRS），并简要介绍了其他方法，包括脑电图（EEG）、单光子发射计算机断层扫描（SPECT）和正电子发射断层扫描（PET）。我们包括了从损伤后 2 个月及以后聚焦于儿童中度至重度 TBI 的研究。虽然儿科 TBI 的发病率相当高，但成像方法的持续进步有可能确定新的治疗靶点，从而显著改善预后。
