摘要
创伤性脑损伤(traumatic brain injury,TBI)后在原发病灶周围存在可动态发展区域,该区域可以恢复正常,也可以转变为不可逆损伤,称为创伤半暗带(contusion penumbra,CP).目前关于创伤半暗带的病生理改变尚未明确,研究认为该区域的主要生理改变包括:脑血流量改变、脑水肿发生、细胞凋亡与坏死等.创伤半暗带的发展结果与患者预后密切相关,是临床观察与治疗的重点.现今利用多模态磁共振技术观察创伤半暗带的方法较多,如扩散加权成像、磁敏感加权成像、灌注加权成像、弥散张量成像、扩散峰度成像、氢质子波谱成像、定量磁敏感图等,也存在多种界定创伤半暗带范围的方法,但对于界定方法尚未有统一定论.本文就脑创伤半暗带的病生理改变及影像学研究进展方面进行综述.
Abstract
After traumatic brain injury(TBI),there is a dynamic development area around the primary lesion,which can return to normal or turn into irreversible injury,which is called contusion penumbra(CP).At present,the pathophysiological changes of the traumatic penumbra are not clear.Studies suggest that the main physiological changes in this region include changes in cerebral blood flow,cerebral edema,apoptosis and necrosis,etc.The development of traumatic penumbra is closely related to the prognosis of patients,which is the focus of clinical observation and treatment.Currently,multi-mode magnetic resonance technology has a plethora of ways to observe the trauma penumbra,such as diffusion-weighted imaging,magnetic sensitive weighted imaging,perfusion weighted imaging,diffusion tensor imaging,diffusion kurtosis imaging,hydrogen proton spectroscopy imaging,and quantitative magnetic sensitive imaging.There are also a variety of methods to define the scope of the trauma penumbra,but there is no unified conclusion on the definition method.A review of the penumbra's pathophysiological alterations and imaging research advancement in traumatic brain injury is presented in this article.
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