Application of advanced neuroimaging modalities in pediatric traumatic brain injury.
Application of advanced neuroimaging modalities in pediatric traumatic brain injury.
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DOI：
10.1177/0883073814538504
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发表时间：
2014-12
影响因子：
1.9
通讯作者：
Holshouser BA
中科院分区：
文献类型：
--
作者：
Ashwal S;Tong KA;Ghosh N;Bartnik-Olson B;Holshouser BA
神经影像学通常用于评估儿童创伤性脑损伤，并大大提高了儿童急性评估的方法。最近，重点已经集中在如何先进的磁共振成像方法可以检测微妙的损伤，可能涉及到经常发生的神经心理和行为改变的结构基础。我们研究了几种用于评估小儿脑损伤的方法。磁敏感加权成像是检测弥漫性轴索损伤相关出血性病变的一种敏感的三维高分辨率技术。磁共振波谱获取代谢物信息，其作为神经元（和神经胶质、脂质等）结构完整性的代表，并提供神经化学改变的敏感评估。弥散加权成像对缺血性损伤和剪切性损伤的早期发现是有用的。扩散张量成像可以更好地评价白色物质束的结构。这些方法在显示儿童临床症状下的细微损伤方面比传统成像更敏感。人们也越来越希望开发计算方法来融合成像数据，以提供对神经血管单元的组成部分受到影响的程度的更综合的分析。创伤性脑损伤神经影像学研究的未来是有希望的，并将导致新的方法来预测和改善结果。
Neuroimaging is commonly used for the assessment of children with traumatic brain injury and has greatly advanced how children are acutely evaluated. More recently, emphasis has focused on how advanced magnetic resonance imaging methods can detect subtler injuries that could relate to the structural underpinnings of the neuropsychological and behavioral alterations that frequently occur. We examine several methods used for the assessment of pediatric brain injury. Susceptibility-weighted imaging is a sensitive 3-dimensional high-resolution technique in detecting hemorrhagic lesions associated with diffuse axonal injury. Magnetic resonance spectroscopy acquires metabolite information, which serves as a proxy for neuronal (and glial, lipid, etc) structural integrity and provides sensitive assessment of neurochemical alterations. Diffusion-weighted imaging is useful for the early detection of ischemic and shearing injury. Diffusion tensor imaging allows better structural evaluation of white matter tracts. These methods are more sensitive than conventional imaging in demonstrating subtle injury that underlies a child’s clinical symptoms. There also is an increasing desire to develop computational methods to fuse imaging data to provide a more integrated analysis of the extent to which components of the neurovascular unit are affected. The future of traumatic brain injury neuroimaging research is promising and will lead to novel approaches to predict and improve outcomes.
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