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预测脑出血血肿扩大的影像学标志物研究进展:一项叙述性综述

Research advances in imaging markers for predicting hematoma expansion in intracerebral hemorrhage: a narrative review.

作者信息

Huang Yong-Wei, Huang Hai-Lin, Li Zong-Ping, Yin Xiao-Shuang

机构信息

Department of Neurosurgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, China.

Department of Immunology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, China.

出版信息

Front Neurol. 2023 Apr 25;14:1176390. doi: 10.3389/fneur.2023.1176390. eCollection 2023.

Abstract

INTRODUCTION

Stroke is a major global health concern and is ranked as the second leading cause of death worldwide, with the third highest incidence of disability. Intracerebral hemorrhage (ICH) is a devastating form of stroke that is responsible for a significant proportion of stroke-related morbidity and mortality worldwide. Hematoma expansion (HE), which occurs in up to one-third of ICH patients, is a strong predictor of poor prognosis and can be potentially preventable if high-risk patients are identified early. In this review, we provide a comprehensive summary of previous research in this area and highlight the potential use of imaging markers for future research studies.

RECENT ADVANCES

Imaging markers have been developed in recent years to aid in the early detection of HE and guide clinical decision-making. These markers have been found to be effective in predicting HE in ICH patients and include specific manifestations on Computed Tomography (CT) and CT Angiography (CTA), such as the spot sign, leakage sign, spot-tail sign, island sign, satellite sign, iodine sign, blend sign, swirl sign, black hole sign, and hypodensities. The use of imaging markers holds great promise for improving the management and outcomes of ICH patients.

CONCLUSION

The management of ICH presents a significant challenge, and identifying high-risk patients for HE is crucial to improving outcomes. The use of imaging markers for HE prediction can aid in the rapid identification of such patients and may serve as potential targets for anti-HE therapies in the acute phase of ICH. Therefore, further research is needed to establish the reliability and validity of these markers in identifying high-risk patients and guiding appropriate treatment decisions.

摘要

引言

中风是全球主要的健康问题,在全球范围内是第二大致死原因,残疾发生率排名第三。脑出血(ICH)是一种毁灭性的中风形式,在全球范围内与中风相关的发病率和死亡率中占很大比例。血肿扩大(HE)发生在多达三分之一的ICH患者中,是预后不良的有力预测指标,如果能早期识别高危患者,血肿扩大可能是可以预防的。在本综述中,我们全面总结了该领域以前的研究,并强调了成像标志物在未来研究中的潜在用途。

最新进展

近年来已开发出成像标志物,以帮助早期检测血肿扩大并指导临床决策。这些标志物已被发现可有效预测ICH患者的血肿扩大,包括计算机断层扫描(CT)和CT血管造影(CTA)上的特定表现,如斑点征、渗漏征、斑点尾征、岛征、卫星征、碘征、融合征、漩涡征、黑洞征和低密度影。成像标志物的使用在改善ICH患者的管理和预后方面具有巨大潜力。

结论

脑出血的管理面临重大挑战,识别血肿扩大的高危患者对于改善预后至关重要。使用成像标志物预测血肿扩大有助于快速识别此类患者,并可能成为脑出血急性期抗血肿扩大治疗的潜在靶点。因此,需要进一步研究以确定这些标志物在识别高危患者和指导适当治疗决策方面的可靠性和有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f74d/10166819/7b032e9bf1e3/fneur-14-1176390-g001.jpg

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