Division of Neurocritical Care, Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Division of Anaesthesia, Department of Medicine, University of Cambridge, Cambridge, United Kingdom.
Semin Neurol. 2022 Jun;42(3):325-334. doi: 10.1055/a-1892-1894. Epub 2022 Jul 5.
Disorder of consciousness (DoC) after severe brain injury presents numerous challenges to clinicians, as the diagnosis, prognosis, and management are often uncertain. Magnetic resonance imaging (MRI) has long been used to evaluate brain structure in patients with DoC. More recently, advances in MRI technology have permitted more detailed investigations of the brain's structural integrity (via diffusion MRI) and function (via functional MRI). A growing literature has begun to show that these advanced forms of MRI may improve our understanding of DoC pathophysiology, facilitate the identification of patient consciousness, and improve the accuracy of clinical prognostication. Here we review the emerging evidence for the application of advanced MRI for patients with DoC.
意识障碍(DoC)是严重脑损伤患者面临的众多挑战之一,因为其诊断、预后和管理常常不确定。磁共振成像(MRI)长期以来一直用于评估 DoC 患者的脑结构。最近,MRI 技术的进步使得对大脑结构完整性(通过弥散 MRI)和功能(通过功能 MRI)进行更详细的研究成为可能。越来越多的文献开始表明,这些先进的 MRI 形式可能会改善我们对 DoC 病理生理学的理解,有助于确定患者的意识,并提高临床预后的准确性。在这里,我们回顾了用于 DoC 患者的先进 MRI 的应用的新出现的证据。