Noninvasive cerebral perfusion imaging in high-risk neonates.
Noninvasive cerebral perfusion imaging in high-risk neonates.
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DOI：
10.1053/j.semperi.2009.10.005
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发表时间：
2010-02
影响因子：
3.4
通讯作者：
Licht DJ
中科院分区：
文献类型：
--
作者：
Goff DA;Buckley EM;Durduran T;Wang J;Licht DJ
对高危新生儿的医疗和外科护理的进步提高了存活率。这些新生儿中有相当一部分患有神经发育迟缓和学业失败。临床研究的重点已经转移到了解这些患者的神经系统发病率的事件。评估脑氧合和脑血流量（CBF）调节的变化对评估中枢神经系统的状态非常重要。传统的CBF成像方法由于伦理和后勤原因而失败。光学近红外光谱（NIRS）越来越多地用于床旁监测极低出生体重儿和先天性心脏病新生儿的脑氧合和血容量。虽然CBF的趋势可以从脑氧合和/或血容量的变化推断，但NIRS不允许直接测量这些人群的CBF。两个相对较新的方式，动脉自旋标记灌注磁共振成像和光学弥散相关光谱，提供了直接的，非侵入性的措施，脑灌注适合于高危新生儿。在这里，我们讨论的仪器，应用程序和这些非侵入性成像技术测量和/或监测脑血流的局限性。
Advances in medical and surgical care of the high-risk neonate have led to increased survival. A significant number of these neonates suffer from neurodevelopmental delays and failure in school. The focus of clinical research has shifted to understanding events contributing to neurological morbidity in these patients. Assessing changes in cerebral oxygenation and regulation of cerebral blood flow (CBF) is important in evaluating the status of the central nervous system. Traditional CBF imaging methods fail for both ethical and logistical reasons. Optical near infrared spectroscopy (NIRS) is increasingly being used for bedside monitoring of cerebral oxygenation and blood volume in both very low birth weight infants and neonates with congenital heart disease. Although trends in CBF may be inferred from changes in cerebral oxygenation and/or blood volume, NIRS does not allow a direct measure of CBF in these populations. Two relatively new modalities, arterial spin-labeled perfusion magnetic resonance imaging and optical diffuse correlation spectroscopy, provide direct, noninvasive measures of cerebral perfusion suitable for the high-risk neonates. Herein we discuss the instrumentation, applications, and limitations of these noninvasive imaging techniques for measuring and/or monitoring CBF.
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