Assistant Professor of Psychiatry (Child), Washington University School of Medicine in St. Louis, Missouri.
Professor of Psychiatry, Neurology, Radiology, and Neuroscience at Washington University School of Medicine in St. Louis, Missouri.
Mo Med. 2024 Jan-Feb;121(1):37-43.
Technologies in the 21st century provide increasingly detailed and accurate maps of brain structure and function. So why don't psychiatrists order brain imaging on all our patients? Here we briefly review major neuroimaging methods and some of their findings in psychiatry. As clinicians and neuroimaging researchers, we are eager to bring brain imaging into daily clinical practice. However, to be clinically useful, any test in medicine must demonstrate adequate test statistics, and show proven benefits that outweigh its risks and costs. In 2024, beyond certain limited circumstances, we have no imaging tests that can meet those standards to provide diagnosis or guide treatment. This cold fact explains why for most psychiatric patients, neuroimaging is not currently recommended by professional organizations or the National Institute of Mental Health.
21 世纪的技术为我们提供了越来越详细和精确的大脑结构和功能图谱。那么，为什么精神科医生不在所有患者身上都开脑部影像学检查呢？在这里，我们简要回顾了主要的神经影像学方法及其在精神病学中的部分发现。作为临床医生和神经影像学研究人员，我们渴望将脑成像技术应用于日常临床实践中。然而，要在临床上有用，医学中的任何检测都必须具有足够的统计学意义，并显示出其益处超过风险和成本。到 2024 年，在某些特定情况下，我们还没有任何影像学检测能够达到这些标准，从而提供诊断或指导治疗。这一残酷的事实解释了为什么对于大多数精神科患者来说，神经影像学目前还没有得到专业组织或美国国家精神卫生研究所的推荐。
