基于多模态影像学的轻度创伤性脑损伤脑功能评估的研究进展  

Research advances in clinical diagnosis of mild traumatic brain injury based on multimodal imaging

作　　者：倪立桐 齐琦 马珩钞 曹征涛 张玉艳 牛田力 官志强 胡坚兴 宁亚蕾 王卫东[4] 马林[1] 李小俚[5] 雍政 罗勇军 李平 张军[8] 李世俊[1] NI Litong;QI Qi;MA Hengchao;CAO Zhengtao;ZHANG Yuyan;NIU Tianli;GUAN Zhiqiang;HU Jianxing;NING Yalei;WANG Weidong;MA Lin;LI Xiaoli;YONG Zheng;LUO Yongjun;LI Ping;ZHANG Jun;LI Shijun(Department of Radiology,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Air Force Medical Center,Beijing 100142,China;Army Health Service Training Base,Army Medical University,Chongqing 400038,China;Medical Innovation Research Division,Chinese PLA General Hospital,Beijing 100853,China;State Key Laboratory of Cognitive Neuroscience and Learning,Beijing Normal University,Beijing 100875,China;Institute of Pharmacology and Toxicology,Academy of Military Medical Sciences,Beijing 100850,China;The Third Affiliated Hospital of Army Medical University,Field Surgery Research Institute,Chongqing 400037,China;Department of Neurosurgery,the Six Medical Center,Chinese PLA General Hospital,Beijing 100048,China)

机构地区：[1]解放军总医院第一医学中心放射诊断科,北京100853 [2]空军特色医学中心,北京100142 [3]陆军军医大学陆军卫勤训练基地,重庆400038 [4]解放军总医院医学创新研究部,北京100853 [5]北京师范大学认知神经科学与学习国家重点实验室,北京100875 [6]军事科学院军事医学研究院毒物药物研究所,北京100850 [7]陆军军医大学第三附属医院·野战外科研究所,重庆400037 [8]解放军总医院第六医学中心神经外科,北京100048

出　　处：《解放军医学院学报》2024年第7期805-810,F0003,共7页Academic Journal of Chinese PLA Medical School

基　　金：国家自然科学基金面上项目(81971603)。

摘　　要：轻度创伤性脑损伤(mild traumatic brain injury,mTBI)具有病理生理复杂、早期诊断难、伴有不同程度脑功能障碍等特点,需早期干预才能有效恢复如注意力不集中、记忆力减退等脑功能障碍。上述功能障碍与大脑默认网络、海马、基底节等脑区功能异常密切关联,而影像学可以准确量化评估这些脑功能区的改变。高场强磁共振成像技术的出现,使得影像学成为mTBI临床早期诊断与临床治疗评估的关键技术。基于mTBI动物模型及临床患者,本文从磁共振成像中反映工作记忆的动脉自旋回波、反映认知缺陷的弥散张量成像、反映淋巴转运异常的超高场强磁共振增强成像以及反映颅脑冲击伤损伤程度的正电子发射计算机断层扫描术与脑电图等方面作一综述,旨在为mTBI军事医学研究提供参考。Mild traumatic brain injury(mTBI)has the characteristics of complex pathophysiology,difficulty in early diagnosis,and often accompanies by different degrees of brain dysfunction.Early intervention is required to effectively restore deficits such as attention and memory.The above-mentioned dysfunctions are closely related to the functional abnormalities of the default network,hippocampus,basal ganglia and other brain areas,and imaging can accurately quantitatively evaluate the changes in these brain functional areas,especially the emergence of high-field magnetic resonance imaging technology,which has become a key technology for early clinical diagnosis and clinical treatment evaluation of mTBI.Based on mTBI animal models and clinical patients,this paper analyzes arterial spin labeling(ASL)reflecting working memory in magnetic resonance imaging(MRI),diffusion tensor imaging(DTI)for cognitive deficits,and ultra-high-field magnetic resonance imaging for abnormal lymphatic transport.Resonance-enhanced imaging,as well as positron emission computed tomography(PET)and electroencephalography(EEG)studies that reflect the degree of traumatic brain injury are reviewed,which may provide references for military medical research of mTBI.

关 键 词：多模态影像学 轻度创伤性脑损伤 磁共振成像 mTBI动物模型 脑功能成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R651.15[医药卫生—诊断学]