|
DWI阴性急性脑梗死影像学新技术应用研究进展
|
Abstract:
传统的影像学检查如CT和MRI已在急性脑梗死的诊断中发挥重要作用,但DWI阴性情况的出现提示了诊断的复杂性,这类患者的早期诊断和治疗对预后至关重要。本文综述了急性脑梗死影像学新技术应用研究的进展,特别关注了DWI阴性急性脑梗死的诊断挑战与新技术的应用。功能MRI、PET和SPECT等因其能够提供更详细的功能与代谢信息而被视为提高DWI阴性急性脑梗死诊断率的关键。这些新技术展示了早期识别微小梗死和早期脑梗死的潜能,有助于区分暂时性缺血与不可逆的脑组织坏死。然而,新兴技术的临床应用仍面临挑战。未来研究应集中于新技术的标准化、普及化、与传统技术的结合及成本效益分析,同时结合大数据和人工智能技术优化图像分析,可能进一步提高DWI阴性急性脑梗死的诊断准确性和治疗效果。
Traditional imaging tests such as CT and MRI have played an important role in the diagnosis of acute cerebral infarction, but the emergence of DWI-negative cases suggests the complexity of the diagnosis, and the early diagnosis and treatment of these patients are crucial to the prognosis. This article reviews the progress of research on the application of new imaging techniques in acute cerebral infarction, with a special focus on the diagnostic challenges of DWI-negative acute cerebral infarction and the application of new techniques. Functional MRI, PET, and SPECT are seen as key to improving the diagnostic rate of DWI-negative acute cerebral infarction due to their ability to provide more detailed functional and metabolic information. These new techniques demonstrate the potential for early identification of microinfarcts and early cerebral infarction and help to differentiate between transient ischaemia and irreversible brain tissue necrosis. However, the clinical application of emerging technologies still faces challenges. Future research should focus on the standardisation, popularisation, integration with traditional techniques and cost-benefit analysis of new techniques, while optimising image analysis by combining big data and artificial intelligence techniques, which may further improve the diagnostic accuracy and therapeutic efficacy of DWI-negative acute cerebral infarction.
[1] | Brunser, A.M., Hoppe, A., Illanes, S., Díaz, V., Muñoz, P., Cárcamo, D., et al. (2013) Accuracy of Diffusion-Weighted Imaging in the Diagnosis of Stroke in Patients with Suspected Cerebral Infarct. Stroke, 44, 1169-1171. https://doi.org/10.1161/strokeaha.111.000527 |
[2] | 鲁奎, 郑龙. 急性脑梗死DWI阴性原因分析[J]. 临床荟萃, 2021, 36(8): 753-756. |
[3] | Shono, K., Satomi, J., Tada, Y., Kanematsu, Y., Yamamoto, N., Izumi, Y., et al. (2017) Optimal Timing of Diffusion-Weighted Imaging to Avoid False-Negative Findings in Patients with Transient Ischemic Attack. Stroke, 48, 1990-1992. https://doi.org/10.1161/strokeaha.117.014576 |
[4] | 李晓丽, 段瑞生, 张兆旭, 等. DWI阴性的急性缺血性脑卒中1例并文献分析[J]. 中风与神经疾病杂志, 2018, 35(5): 467-468. |
[5] | Zuo, L., Zhang, Y., Xu, X., Li, Y., Bao, H., Hao, J., et al. (2015) A Retrospective Analysis of Negative Diffusion-Weighted Image Results in Patients with Acute Cerebral Infarction. Scientific Reports, 5, Article No. 8910. https://doi.org/10.1038/srep08910 |
[6] | 刘长英, 周莉, 张根明, 等. 功能磁共振成像在急性脑梗死中应用的研究进展[J]. 中西医结合心脑血管病杂志, 2020, 18(12): 1894-1897. |
[7] | 潘一为. 神经退行性疾病PET影像自动定量分析方法研究[D]: [硕士学位论文]. 哈尔滨: 哈尔滨工业大学, 2022. |
[8] | 毛亚冬, 石磊. PET在脑动脉粥样硬化斑块稳定性及缺血性脑血管病病情评估中的应用进展[J]. 山东医药, 2022, 62(27): 87-92. |
[9] | Tsukada, H., Ohba, H., Nishiyama, S., Kanazawa, M., Kakiuchi, T. and Harada, N. (2014) PET Imaging of Ischemia-Induced Impairment of Mitochondrial Complex I Function in Monkey Brain. Journal of Cerebral Blood Flow & Metabolism, 34, 708-714. https://doi.org/10.1038/jcbfm.2014.5 |
[10] | 崔碧霄, 张苗, 马杰. 一体化18F-FDG PET/MR评估缺血性脑血管病[J]. 中国医学影像技术, 2019, 35(12): 1817-1822. |
[11] | Ssali, T., Anazodo, U.C., Thiessen, J.D., Prato, F.S. and St. Lawrence, K. (2018) A Noninvasive Method for Quantifying Cerebral Blood Flow by Hybrid PET/MRI. Journal of Nuclear Medicine, 59, 1329-1334. https://doi.org/10.2967/jnumed.117.203414 |
[12] | 罗雨晴, 陈科威, 潘君龙. 超快速动态增强MRI在乳腺癌中的研究进展[J]. 影像诊断与介入放射学, 2024, 33(2): 134-140. |
[13] | 汤亚云. 磁共振扩散张量成像及纤维束成像在急性脑梗死中的临床应用研究[D]: [硕士学位论文]. 百色: 右江民族医学院, 2021. |
[14] | 曹晓轩, 宗素英, 白秀艳. 磁共振弥散加权成像对急性脑梗死的诊断作用及优于MRI常规检查特征[J]. 中国CT和MRI杂志, 2020, 18(7): 22-25. |