轻型颅脑创伤影像学研究进展

doi:10.3969/j.issn.1672-6731.2025.09.005

中国现代神经疾病杂志 ›› 2025, Vol. 25 ›› Issue (9): 807-813. doi: 10.3969/j.issn.1672-6731.2025.09.005

2 轻型颅脑创伤影像学研究进展

郭一丁¹, 温佳奇², 刘勇³, 薛蓉², 郭华⁴, 郭毅¹^,*()

1. 102218 清华大学附属北京清华长庚医院神经外科
2. 100101 北京，中国科学院生物物理研究所脑与认知科学国家重点实验室
3. 017000 内蒙古自治区鄂尔多斯中心医院神经外科
4. 100084 北京，清华大学生物医学工程系

收稿日期:2025-04-03 出版日期:2025-09-25 发布日期:2025-10-17
通讯作者: 郭毅
作者简介:
郭一丁与温佳奇对本文有同等贡献

GUO Yi-ding and WEN Jia-qi contributed equally to the article
基金资助:
国家自然科学基金资助项目(U20A20389); 清华大学精准医学科研计划战略项目(12024Z01017)

Progress on imaging research of mild traumatic brain injury

Yi-ding GUO¹, Jia-qi WEN², Yong LIU³, Rong XUE², Hua GUO⁴, Yi GUO¹^,*()

1. Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing 102218, China
2. State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China
3. Department of Neurosurgery, The Ordos Central Hospital, Ordos 017000, Inner Mongolia, China
4. School of Biomedical Engineering, Tsinghua University, Beijing 100084, China

Received:2025-04-03 Online:2025-09-25 Published:2025-10-17
Contact: Yi GUO
Supported by:
the National Natural Science Foundation of China(U20A20389); Beijing Tsinghua Changgung Hospital Fund(12024Z01017)

摘要/Abstract

摘要：

轻型颅脑创伤是最常见的中枢神经系统疾病，传统诊断依赖患者症状和临床医师主观判断，缺乏客观诊断手段，极易忽视，导致临床预后不良。随着影像学技术的发展，磁敏感加权成像、FLAIR成像、磁共振波谱、扩散张量成像、fMRI等新兴技术为轻型颅脑创伤的诊断与管理及预后评估提供新的可能性，更有效检出脑组织微观病理变化，辅助评估疗效及预后。本文系统阐述上述特殊或新兴影像学技术在轻型颅脑创伤诊断与预后评估中的作用及其在未来研究中的潜在应用，加深临床医师对疾病的了解并为临床实践提供参考。

关键词: 脑损伤，创伤性, 磁共振成像, 综述

Abstract:

Mild traumatic brain injury (mTBI) is the most common central nervous system disease. The diagnosis of conventional mTBI primarily relies on patient-reported symptoms and the subjective clinical judgment of clinical physician, which lacks objective diagnostic methods and easily contributed to neglect and result in poor clinical prognosis. However, with the continuous advancement of imaging technologies, emerging modalities such as susceptibility-weighted imaging (SWI), FLAIR, magnetic resonance spectrum (MRS), diffusion tensor imaging (DTI) and functional magnetic resonance imaging (fMRI), have provided new opportunities for the diagnosis, management and prognostic assessment of mTBI. These imaging technologies offer enhanced capabilities for detecting microscopic pathological alterations in brain tissue, facilitating the evaluation of treatment efficacy and long-term prognosis. This article systematically elaborates on the role of the aforementioned specialized or emerging imaging technologies in the diagnosis and prognostic assessment of mTBI, as well as their potential applications in future research, deepening clinical's understand of disease and providing a reference for clinical practice.

Key words: Brain injuries, traumatic, Magnetic resonance imaging, Review

郭一丁, 温佳奇, 刘勇, 薛蓉, 郭华, 郭毅. 轻型颅脑创伤影像学研究进展[J]. 中国现代神经疾病杂志, 2025, 25(9): 807-813.

Yi-ding GUO, Jia-qi WEN, Yong LIU, Rong XUE, Hua GUO, Yi GUO. Progress on imaging research of mild traumatic brain injury[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2025, 25(9): 807-813.

https://journal11.magtechjournal.com/cjcnn/CN/Y2025/V25/I9/807

图/表 3

图 1 轻型颅脑创伤患者横断面SWI序列显示，左侧海马小片状低信号影，考虑微出血（箭头所示）

Figure 1 Axial SWI showed a little patch-shaped hypointensity, indicating CMBs in the left hippocampus in mTBI patient (arrow indicates).

图 2 轻型颅脑创伤患者横断面FLAIR成像显示，右侧扣带回下点状略高信号影，提示脑白质高信号相关病变（箭头所示）

Figure 2 Axial FLAIR showed the punctate slightly hyperintensity, indicating MWH related lesion in the right cingulate gyrus in mTBI patient (arrow indicates).

图 3 DTI序列分析后生成处理结果 3a 横断面编码彩色FA图像显示白质纤维束走行方向（红色示纤维束沿左右方向走行，绿色示纤维束沿前后方向走行，蓝色示纤维束沿头足方向走行） 3b 横断面FA图像所示高信号区域代表体素内水分子走行各向异性明显，即白质纤维束走行区 3c 横断面ADC图像所示信号代表体素内水分子扩散程度

Figure 3 The post-processing outcomes from DTI were displayed as follows Axial color encoded FA (colFA) image showed the white matter fiber orientation, with the color representing the average fiber direction within each voxel. Red indicateed fibers were aligned with the coronal plane (from left to right or vice versa), green was aligned with the sagittal plane (from anterior to posterior or vice versa), and blue was with the axial plane (from superior to inferior or vice versa), respectively (Panel 3a). Axial FA map, where higher signal represented significant anisotropy of water diffusion, indicating the presence of white matter fibers (Panel 3b). Axial ADC image showed the MD of water molecule within local voxel brain tissue (Panel 3c).

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