磁共振成像在颅内动脉瘤性蛛网膜下腔出血中的应用：现有证据与未来方向。
Magnetic Resonance Imaging in Aneurysmal Subarachnoid Hemorrhage: Current Evidence and Future Directions.
机构信息
Department of Neurology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 455, Baltimore, MD, 21287, USA.
Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 455, Baltimore, MD, 21287, USA.
出版信息
Neurocrit Care. 2018 Oct;29(2):241-252. doi: 10.1007/s12028-018-0534-8.
BACKGROUND
Aneurysmal subarachnoid hemorrhage (aSAH) is associated with an unacceptably high mortality and chronic disability in survivors, underscoring a need to validate new approaches for treatment and prognosis. The use of advanced imaging, magnetic resonance imaging (MRI) in particular, could help address this gap given its versatile capacity to quantitatively evaluate and map changes in brain anatomy, physiology and functional activation. Yet there is uncertainty about the real value of brain MRI in the clinical setting of aSAH.
METHODS
In this review, we discuss current and emerging MRI research in aSAH. PubMed was searched from inception to June 2017, and additional studies were then chosen on the basis of relevance to the topics covered in this review.
RESULTS
Available studies suggest that brain MRI is a feasible, safe, and valuable testing modality. MRI detects brain abnormalities associated with neurologic examination, outcomes, and aneurysm treatment and thus has the potential to increase knowledge of aSAH pathophysiology as well as to guide management and outcome prediction. Newer pulse sequences have the potential to reveal structural and physiological changes that could also improve management of aSAH.
CONCLUSION
Research is needed to confirm the value of MRI-based biomarkers in clinical practice and as endpoints in clinical trials, with the goal of improving outcome for patients with aSAH.
背景
颅内动脉瘤性蛛网膜下腔出血（aSAH）与幸存者极高的死亡率和慢性残疾相关，这突显了需要验证新的治疗和预后方法。先进的成像技术，特别是磁共振成像（MRI），由于其能够定量评估和绘制脑解剖、生理和功能激活的变化，因此可能有助于填补这一空白。然而，在 aSAH 的临床环境中，脑 MRI 的实际价值仍存在不确定性。
方法
在本综述中，我们讨论了 aSAH 中当前和新兴的 MRI 研究。从建立到 2017 年 6 月，在 PubMed 上进行了搜索，然后根据与本综述涵盖的主题的相关性选择了其他研究。
结果
现有研究表明，脑 MRI 是一种可行、安全且有价值的检测方式。MRI 可以检测出与神经检查、结果和动脉瘤治疗相关的脑异常，因此有可能增加对 aSAH 病理生理学的了解，并指导管理和预后预测。新的脉冲序列有可能揭示结构和生理变化，这也可能改善 aSAH 的管理。
结论
需要研究来确认基于 MRI 的生物标志物在临床实践中的价值，并作为临床试验的终点，以提高 aSAH 患者的预后。
Zotero 插件