Imaging of cerebral blood flow in patients with severe traumatic brain injury in the neurointensive care

被引:42
作者
Rostami, Elham [1 ,2 ]
Engquist, Henrik [3 ]
Enblad, Per [1 ]
机构
[1] Uppsala Univ, Dept Neurosci, Sect Neurosurg, SE-75185 Uppsala, Sweden
[2] Karolinska Inst, Dept Neurosci, Stockholm, Sweden
[3] Uppsala Univ, Dept Surg Sci Anaesthesiol & Intens Care, SE-75185 Uppsala, Sweden
关键词
cerebral blood flow; brain injury; neurointensive care; Xenon-CT; imaging; POSITRON-EMISSION-TOMOGRAPHY; PERFUSION-DIFFUSION MISMATCH; SEVERE HEAD-INJURY; XENON-CT; GLUCOSE-UTILIZATION; XE-CT; METABOLISM; ISCHEMIA; DAMAGE; THRESHOLDS;
D O I
10.3389/fneur.2014.00114
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Ischemia is a common and deleterious secondary injury following traumatic brain injury (TBI). A great challenge for the treatment of TBI patients in the neurointensive care unit (NICU) is to detect early signs of ischemia in order to prevent further advancement and deterioration of the brain tissue. Today, several imaging techniques are available to monitor cerebral blood flow (CBF) in the injured brain such as positron emission tomography (PET), single-photon emission computed tomography, xenon computed tomography (Xenon-CT), perfusion-weighted magnetic resonance imaging (MRI), and CT perfusion scan. An ideal imaging technique would enable continuous non-invasive measurement of blood flow and metabolism across the whole brain. Unfortunately, no current imaging method meets all these criteria. These techniques offer snapshots of the CBE MRI may also provide some information about the metabolic state of the brain. PET provides images with high resolution and quantitative measurements of CBF and metabolism; however, it is a complex and costly method limited to few TBI centers. All of these methods except mobile Xenon-CT require transfer of TBI patients to the radiological department. Mobile Xenon-CT emerges as a feasible technique to monitor CBF in the NICU, with lower risk of adverse effects. Promising results have been demonstrated with Xenon-CT in predicting outcome in TBI patients. This review covers available imaging methods used to monitor CBF in patients with severe TBI.
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页数:9
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