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非侵入性和微创性脑自动调节评估:技术综述及其对临床研究的意义

Non-Invasive and Minimally-Invasive Cerebral Autoregulation Assessment: A Narrative Review of Techniques and Implications for Clinical Research.

作者信息

Sainbhi Amanjyot Singh, Gomez Alwyn, Froese Logan, Slack Trevor, Batson Carleen, Stein Kevin Y, Cordingley Dean M, Alizadeh Arsalan, Zeiler Frederick A

机构信息

Biomedical Engineering, Faculty of Engineering, University of Manitoba, Winnipeg, MB, Canada.

Section of Neurosurgery, Department of Surgery, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.

出版信息

Front Neurol. 2022 Apr 26;13:872731. doi: 10.3389/fneur.2022.872731. eCollection 2022.

Abstract

The process of cerebral vessels regulating constant cerebral blood flow over a wide range of systemic arterial pressures is termed cerebral autoregulation (CA). Static and dynamic autoregulation are two types of CA measurement techniques, with the main difference between these measures relating to the time scale used. Static autoregulation looks at the long-term change in blood pressures, while dynamic autoregulation looks at the immediate change. Techniques that provide regularly updating measures are referred to as continuous, whereas intermittent techniques take a single at point in time. However, a technique being continuous or intermittent is not implied by if the technique measures autoregulation statically or dynamically. This narrative review outlines technical aspects of non-invasive and minimally-invasive modalities along with providing details on the non-invasive and minimally-invasive measurement techniques used for CA assessment. These non-invasive techniques include neuroimaging methods, transcranial Doppler, and near-infrared spectroscopy while the minimally-invasive techniques include positron emission tomography along with magnetic resonance imaging and radiography methods. Further, the advantages and limitations are discussed along with how these methods are used to assess CA. At the end, the clinical considerations regarding these various techniques are highlighted.

摘要

脑血管在广泛的体动脉压范围内调节恒定脑血流量的过程称为脑自动调节(CA)。静态和动态自动调节是两种CA测量技术,这些测量之间的主要区别与所使用的时间尺度有关。静态自动调节着眼于血压的长期变化,而动态自动调节着眼于即时变化。提供定期更新测量值的技术称为连续技术,而间歇性技术则在某一时刻进行单次测量。然而,一种技术是连续的还是间歇性的,并不取决于该技术是静态还是动态测量自动调节。这篇叙述性综述概述了非侵入性和微创方式的技术方面,并详细介绍了用于CA评估的非侵入性和微创测量技术。这些非侵入性技术包括神经成像方法、经颅多普勒和近红外光谱,而微创技术包括正电子发射断层扫描以及磁共振成像和放射成像方法。此外,还讨论了这些方法的优缺点以及它们如何用于评估CA。最后,强调了关于这些各种技术的临床考虑因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20b2/9087842/82d229a90522/fneur-13-872731-g0001.jpg

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