Department of Neurology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Semin Neurol. 2023 Oct;43(5):699-711. doi: 10.1055/s-0043-1775790. Epub 2023 Oct 6.
Prognostic imaging biomarkers after acute brain injury inform treatment decisions, track the progression of intracranial injury, and can be used in shared decision-making processes with families. Herein, key established biomarkers and prognostic scoring systems are surveyed in the literature, and their applications in clinical practice and clinical trials are discussed. Biomarkers in acute ischemic stroke include computed tomography (CT) hypodensity scoring, diffusion-weighted lesion volume, and core infarct size on perfusion imaging. Intracerebral hemorrhage biomarkers include hemorrhage volume, expansion, and location. Aneurysmal subarachnoid biomarkers include hemorrhage grading, presence of diffusion-restricting lesions, and acute hydrocephalus. Traumatic brain injury CT scoring systems, contusion expansion, and diffuse axonal injury grading are reviewed. Emerging biomarkers including white matter disease scoring, diffusion tensor imaging, and the automated calculation of scoring systems and volumetrics are discussed.
预后影像学生物标志物可用于指导急性脑损伤后的治疗决策，监测颅内损伤的进展，并可用于与患者家属的共同决策过程。本文综述了文献中关键的已确立的生物标志物和预后评分系统，并讨论了它们在临床实践和临床试验中的应用。急性缺血性卒中的生物标志物包括 CT 密度评分、弥散加权成像上的病灶体积和灌注成像上的核心梗死体积。脑出血的生物标志物包括血肿量、扩大和部位。颅内动脉瘤蛛网膜下腔出血的生物标志物包括出血分级、弥散受限病变的存在和急性脑积水。还回顾了创伤性脑损伤 CT 评分系统、挫伤扩大和弥漫性轴索损伤分级。还讨论了一些新兴的生物标志物，包括脑白质病变评分、弥散张量成像以及评分系统和容积自动计算。
