脑弥漫性轴索损伤影像学研究进展
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摘要
脑弥漫性轴索损伤(DAI)是一种原发性闭合性脑损伤,常引起脑功能障碍、严重者致残甚至死亡。其临床表现往往较重且缺乏特异性,尤其是在早期,因此及时、准确地诊断DAI越来越为临床所重视。但目前常规的影像学检查未能及时发现或发现了却低估了DAI,相信随着医学的进步,医学影像检查新技术、新方法的飞速发展,对DAI的影像学认识有了很大进步。
Diffuse axonal injury( DAI) is a primary brain injury,which often causes brain dysfunction,severe disability or even death. Clinical manifestations are usually serious and lack of specificity,especially in the early stage,so timely and accurate diagnosis of the DAI is increasingly attracting clinical concerns,while routine imaging examinations often fail to detect or underestimate the DAI. With the advances of new technologies and methods in medical imaging recently,the DAI imaging knowledge has made significant progress.
Diffuse axonal injury( DAI) is a primary brain injury,which often causes brain dysfunction,severe disability or even death. Clinical manifestations are usually serious and lack of specificity,especially in the early stage,so timely and accurate diagnosis of the DAI is increasingly attracting clinical concerns,while routine imaging examinations often fail to detect or underestimate the DAI. With the advances of new technologies and methods in medical imaging recently,the DAI imaging knowledge has made significant progress.
引文
[1]何海涛.急性弥漫性轴索损伤磁共振弥散张量成像的实验研究[D].重庆:第三军医大学,2007.
[2]Adams JH,Graham DI,Murray LS,et al.Diffuse axonal injury due to nonmissile head injury in humans:an analysis of 45 cases[J].Ann Neurol,1982,12(6):557-563.
[3]Foda MA,Marmarou A.A new model of diffuse brain injury in rats.Part II:Morphological characterization[J].J Neurosurg,1994,80(2):301-313.
[4]Johnson VE,Stewart W,Smith DH.Widespread T and amy-loid-βpathology many years after a single traumatic brain injury in humans[J].Brain Pathol,2012,22(2):142-149.
[5]Tang-Schomer MD,Johnson VE,Baas PW,et al.Partial interruption of axonal transport due to microtubule breakage accounts for the formation of periodic varicosities after traumatic axonal injury[J].Exp Neurol,2012,233(1):364-372.
[6]曹阳,邹文远.脑弥漫性轴索损伤的影像诊断进展[J].中国老年保健医学,2013,11(1):46-47.
[7]Browne KD,Chen XH,Meaney DF,et al.Mild traumatic brain injury and diffuse axonal injury in swine[J].J Neurotrauma,2011,28(9):1747-1755.
[8]Matsushita M,Hosoda K,Naitoh Y,et al.Utility of diffusion tensor imaging in the acute stage of mild to moderate brain injury for detecting white matter lesions and predicting long-term cognitive function in adults[J].J Neurosurg,2011,115(1):130-139.
[9]Greer JE,Povlishock JT,Jacobs KM.Electrophysiological abnormalities in both axotomized and nonaxotomized pyramidal neurons following mild traumatic brain injury[J].J Neurosci,2012,32(19):6682-6687.
[10]汪林.磁敏感加权成像在创伤性轴索损伤中的应用研究[D].福州:福建医科大学,2011.
[11]张海都,沈志威,孔令梅,等.枕叶皮质磁共振频谱在脑震荡的应用价值[J].磁共振成像,2013,4(2):104-107.
[12]Ezaki Y,Tsutsumi K,Morikawa M,et al.Role of diffusion-weighted magnetic resonance imaging in diffuse axonal injury[J].Acta Radiol,2006,47(7):733-740.
[13]韩成坤,史浩.磁共振在诊断弥漫性轴索损伤中的应用进展[J].医学影像学杂志,2009,19(8):1055-1058.
[14]刘何鹏.SWI及DTI在弥漫性轴索损伤中的应用价值[D].济南:山东大学,2010.
[15]Kinoshita T,Moritani T,Hiwatashi A,et al.Conspicuity of diffuse axonal injury lesions on diffusion-weighted MR imaging[J].Eur J Radiol,2005,56(1):5-11.
[16]李科,金真,张磊,等.DWI及SWI序列对弥漫性轴索损伤的诊断价值[J].中华神经外科疾病研究杂志,2010,9(2):116-119.
[17]Babikian T,Tong KA,Galloway NR,et al.Diffusion-weighted imaging predicts cognition in pediatric brain injury[J].Pediatr Neurol,2009,41(6):406-412.
[18]Oni MB,Wilde EA,Bigler ED,et al.Diffusion tensor imaging analysis of frontal lobes in pediatric traumatic brain injury[J].J Child Neurol,2010,25(8):976-984.
[19]Hurley RA,Mc Gowan JC,Arfanakis K,et al.Traumatic axonal injury:novel insights into evolution and identification[J].J Neuropsychiatry Clin Neurosci,2004,16(1):1-7.
[20]Mac Donald CL,Johnson AM,Cooper D,et al.Detection of blastrelated traumatic brain injury in U.S.military personnel[J].N Engl J Med,2011,364(22):2091-2100.
[21]Sorensen AG,Wu O,Copen WA,et al.Human acute cerebral ischemia:detection of changes in water diffusion anisotropy by using MR imaging[J].Radiology,1999,212(3):785-792.
[22]Huisman TA,Schwamm LH,Schaefer PW,et al.Diffusion tensor imaging as potential biomarker of white matter injury in diffuse axonal injury[J].AJNR Am J Neuroradiol,2004,25(3):370-376.
[23]Benson RR,Meda SA,Vasudevan S,et al.Global white matter analysis of diffusion tensor images is predictive of injury severity in traumatic brain injury[J].J Neurotrauma,2007,24(3):446-459.
[24]Bennett RE,Mac Donald CL,Brody DL.Diffusion tensor imaging detects axonal injury in a mouse model of repetitive closed-skull teaumatic brain injury[J].Neurosci Lett,2012,513(2):160-165.
[25]Kurowski B,Wade SL,Cecil KM,et al.Correlation of diffusion tensor imaging with executive function measures after early childhood traumatic brain injury[J].J Pediatr Rehabil Med,2009,2(4):273-283.
[26]Mac Donald CL,Dikranian K,Song SK,et al.Detection of traumatic axonal injury with diffusion tensor imaging in a mouse model of traumatic brain injury[J].Exp Neurol,2007,205(1):116-131.
[27]杨正汉,冯逢,王霄英,等.磁共振成像技术指南[M].2版.北京:人民军医出版社,2011:324-333.
[28]郏潜新,欧阳林,岳翠,等.SWI在弥漫性轴索损伤诊断中的价值[J].医学影像学杂志,2010,20(9):1260-1262.
[29]Tong KA,Ashwal S,Holshouser BA,et al.Hemorrhagic shearing lesions in children and adolescents with posttraumatic diffuse axonal injury:improved detection and initial results[J].Radiology,2003,227(2):332-339.
[30]Tong KA,Ashwal S,Holshouser BA,et al.Diffuse axonal injury in children:clinical correlation with hemorrhagic lesions[J].Ann Neurol,2004,56(1):36-50.
[31]Maxwell WL,Mac Kinnon MA,Stewart JE,et al.Stereology of cerebral cortex after traumatic brain injury matched to the Glasgow outcome score[J].Brain,2010,133(Pt 1):139-160.
[32]韩成坤,史浩,刘桂芳,等.磁敏感加权成像对弥漫性轴索损伤的诊断价值[J].中华放射学杂志,2011,45(7):632-636.
[33]程崇杰,孙晓川,尧瑶.临床征象对弥漫性轴索损伤患者预后判断的价值[J].中华创伤杂志,2012,28(3):215-219.
[34]Holshouser BA,Tong KA,Ashwal S.Proton MR spectroscopic imaging depicts diffuse axonal injury in children with traumatic brain injury[J].AJNR Am J Neuroradiol,2005,26(5):1276-1285.
[35]Cecil KM,Lenkinski RE,Meaney DF,et al.High-field proton magnetic resonance spectroscopy of a swine model for axonal injury[J].J Neurochem,1998,70(5):2038-2044.
[36]Smith DH,Cecil KM,Meaney DF,et al.Magnetic resonance spectroscopy of diffuse brain trauma in the pig[J].J Neurotrauma,1998,15(9):665-674.
[37]张海都.弥漫性轴索损伤共振频谱及弥散张量成像定量研究[D].汕头:汕头大学,2009.
[38]Govind V,Gold S,Kaliannan K,et al.Whole-brain proton MR spectroscopic imaging of mild-to-moderate traumatic brain injury and correlation with neuropsychological defi-cits[J].J Neurotrauma,2010,27(3):483-496.
[39]李雪元,王博成,冯东福,等.弥漫性轴索损伤早期质子磁共振波谱研究[J].上海交通大学学报:医学版,2009,29(12):1443-1446.
[40]周和平,牟朝辉,吴剑.质子磁共振波谱分析在原发性脑干损伤中的应用[J].复旦学报:医学版,2011,38(5):413-417.
[2]Adams JH,Graham DI,Murray LS,et al.Diffuse axonal injury due to nonmissile head injury in humans:an analysis of 45 cases[J].Ann Neurol,1982,12(6):557-563.
[3]Foda MA,Marmarou A.A new model of diffuse brain injury in rats.Part II:Morphological characterization[J].J Neurosurg,1994,80(2):301-313.
[4]Johnson VE,Stewart W,Smith DH.Widespread T and amy-loid-βpathology many years after a single traumatic brain injury in humans[J].Brain Pathol,2012,22(2):142-149.
[5]Tang-Schomer MD,Johnson VE,Baas PW,et al.Partial interruption of axonal transport due to microtubule breakage accounts for the formation of periodic varicosities after traumatic axonal injury[J].Exp Neurol,2012,233(1):364-372.
[6]曹阳,邹文远.脑弥漫性轴索损伤的影像诊断进展[J].中国老年保健医学,2013,11(1):46-47.
[7]Browne KD,Chen XH,Meaney DF,et al.Mild traumatic brain injury and diffuse axonal injury in swine[J].J Neurotrauma,2011,28(9):1747-1755.
[8]Matsushita M,Hosoda K,Naitoh Y,et al.Utility of diffusion tensor imaging in the acute stage of mild to moderate brain injury for detecting white matter lesions and predicting long-term cognitive function in adults[J].J Neurosurg,2011,115(1):130-139.
[9]Greer JE,Povlishock JT,Jacobs KM.Electrophysiological abnormalities in both axotomized and nonaxotomized pyramidal neurons following mild traumatic brain injury[J].J Neurosci,2012,32(19):6682-6687.
[10]汪林.磁敏感加权成像在创伤性轴索损伤中的应用研究[D].福州:福建医科大学,2011.
[11]张海都,沈志威,孔令梅,等.枕叶皮质磁共振频谱在脑震荡的应用价值[J].磁共振成像,2013,4(2):104-107.
[12]Ezaki Y,Tsutsumi K,Morikawa M,et al.Role of diffusion-weighted magnetic resonance imaging in diffuse axonal injury[J].Acta Radiol,2006,47(7):733-740.
[13]韩成坤,史浩.磁共振在诊断弥漫性轴索损伤中的应用进展[J].医学影像学杂志,2009,19(8):1055-1058.
[14]刘何鹏.SWI及DTI在弥漫性轴索损伤中的应用价值[D].济南:山东大学,2010.
[15]Kinoshita T,Moritani T,Hiwatashi A,et al.Conspicuity of diffuse axonal injury lesions on diffusion-weighted MR imaging[J].Eur J Radiol,2005,56(1):5-11.
[16]李科,金真,张磊,等.DWI及SWI序列对弥漫性轴索损伤的诊断价值[J].中华神经外科疾病研究杂志,2010,9(2):116-119.
[17]Babikian T,Tong KA,Galloway NR,et al.Diffusion-weighted imaging predicts cognition in pediatric brain injury[J].Pediatr Neurol,2009,41(6):406-412.
[18]Oni MB,Wilde EA,Bigler ED,et al.Diffusion tensor imaging analysis of frontal lobes in pediatric traumatic brain injury[J].J Child Neurol,2010,25(8):976-984.
[19]Hurley RA,Mc Gowan JC,Arfanakis K,et al.Traumatic axonal injury:novel insights into evolution and identification[J].J Neuropsychiatry Clin Neurosci,2004,16(1):1-7.
[20]Mac Donald CL,Johnson AM,Cooper D,et al.Detection of blastrelated traumatic brain injury in U.S.military personnel[J].N Engl J Med,2011,364(22):2091-2100.
[21]Sorensen AG,Wu O,Copen WA,et al.Human acute cerebral ischemia:detection of changes in water diffusion anisotropy by using MR imaging[J].Radiology,1999,212(3):785-792.
[22]Huisman TA,Schwamm LH,Schaefer PW,et al.Diffusion tensor imaging as potential biomarker of white matter injury in diffuse axonal injury[J].AJNR Am J Neuroradiol,2004,25(3):370-376.
[23]Benson RR,Meda SA,Vasudevan S,et al.Global white matter analysis of diffusion tensor images is predictive of injury severity in traumatic brain injury[J].J Neurotrauma,2007,24(3):446-459.
[24]Bennett RE,Mac Donald CL,Brody DL.Diffusion tensor imaging detects axonal injury in a mouse model of repetitive closed-skull teaumatic brain injury[J].Neurosci Lett,2012,513(2):160-165.
[25]Kurowski B,Wade SL,Cecil KM,et al.Correlation of diffusion tensor imaging with executive function measures after early childhood traumatic brain injury[J].J Pediatr Rehabil Med,2009,2(4):273-283.
[26]Mac Donald CL,Dikranian K,Song SK,et al.Detection of traumatic axonal injury with diffusion tensor imaging in a mouse model of traumatic brain injury[J].Exp Neurol,2007,205(1):116-131.
[27]杨正汉,冯逢,王霄英,等.磁共振成像技术指南[M].2版.北京:人民军医出版社,2011:324-333.
[28]郏潜新,欧阳林,岳翠,等.SWI在弥漫性轴索损伤诊断中的价值[J].医学影像学杂志,2010,20(9):1260-1262.
[29]Tong KA,Ashwal S,Holshouser BA,et al.Hemorrhagic shearing lesions in children and adolescents with posttraumatic diffuse axonal injury:improved detection and initial results[J].Radiology,2003,227(2):332-339.
[30]Tong KA,Ashwal S,Holshouser BA,et al.Diffuse axonal injury in children:clinical correlation with hemorrhagic lesions[J].Ann Neurol,2004,56(1):36-50.
[31]Maxwell WL,Mac Kinnon MA,Stewart JE,et al.Stereology of cerebral cortex after traumatic brain injury matched to the Glasgow outcome score[J].Brain,2010,133(Pt 1):139-160.
[32]韩成坤,史浩,刘桂芳,等.磁敏感加权成像对弥漫性轴索损伤的诊断价值[J].中华放射学杂志,2011,45(7):632-636.
[33]程崇杰,孙晓川,尧瑶.临床征象对弥漫性轴索损伤患者预后判断的价值[J].中华创伤杂志,2012,28(3):215-219.
[34]Holshouser BA,Tong KA,Ashwal S.Proton MR spectroscopic imaging depicts diffuse axonal injury in children with traumatic brain injury[J].AJNR Am J Neuroradiol,2005,26(5):1276-1285.
[35]Cecil KM,Lenkinski RE,Meaney DF,et al.High-field proton magnetic resonance spectroscopy of a swine model for axonal injury[J].J Neurochem,1998,70(5):2038-2044.
[36]Smith DH,Cecil KM,Meaney DF,et al.Magnetic resonance spectroscopy of diffuse brain trauma in the pig[J].J Neurotrauma,1998,15(9):665-674.
[37]张海都.弥漫性轴索损伤共振频谱及弥散张量成像定量研究[D].汕头:汕头大学,2009.
[38]Govind V,Gold S,Kaliannan K,et al.Whole-brain proton MR spectroscopic imaging of mild-to-moderate traumatic brain injury and correlation with neuropsychological defi-cits[J].J Neurotrauma,2010,27(3):483-496.
[39]李雪元,王博成,冯东福,等.弥漫性轴索损伤早期质子磁共振波谱研究[J].上海交通大学学报:医学版,2009,29(12):1443-1446.
[40]周和平,牟朝辉,吴剑.质子磁共振波谱分析在原发性脑干损伤中的应用[J].复旦学报:医学版,2011,38(5):413-417.