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Abstract：
Objective. There exists uncertainty regarding the role of magnetic resonance imaging in the evaluation of intensive care unit delirious patients. This case series describes preliminary magnetic resonance imaging findings obtained because of delirium, subsequent in-hospital clinical decisions, and post-discharge neurocognitive outcomes in intensive care unit survivors.Design. Case series.Setting. Intensive care unit.Participants. Eight patients who underwent magnetic resonance imaging for delirium in the absence of focal neurological findings as part of their intensive care unit clinical care.Measurements. Magnetic resonance imaging findings, clinical decisions following magnetic resonance imaging, and three-month neuropsychological outcomes were obtained.Results. Of the eight patients, six (75%) demonstrated white matter hyperintensities, one (12%) had mild atrophy, and no patient had ischemic/hemorrhagic lesions. Magnetic resonance imaging did not lead to new diagnoses or immediate changes in therapy. All six patients who underwent neuropsychological testing had severe impairments in memory, executive function, and attention at three months, despite the absence of baseline cognitive impairment.Conclusion. Magnetic resonance imaging findings in these delirious intensive care unit patients did not alter the immediate treatment course and these patients had neuropsychological impairments at three months. Future research is warranted to define the role of current and newer magnetic resonance imaging techniques in assessing and managing delirious intensive care unit patients, and to examine relationships between in-hospital magnetic resonance imaging findings (i.e. white matter hyperintensities) and short- and long-term neurological outcomes.
摘要：
Objective.磁共振成像在重症监护病房谵妄患者评估中的作用存在不确定性。本病例系列描述了由于谵妄而获得的初步磁共振成像发现，随后的住院临床决策，和重症监护病房幸存者的出院后神经认知结果。设计。案例系列。设置。重症监护室.参与者。八名在重症监护病房临床护理中没有局灶性神经系统发现的情况下接受磁共振成像谵妄的患者。测量。磁共振成像发现，磁共振成像后的临床决策，并获得3个月的神经心理学结果。结果。八个病人中,六个（75％）表现出白质高强度，其中一人（12%）有轻度萎缩，无患者出现缺血/出血性病变。磁共振成像没有导致新的诊断或立即改变治疗。所有6名接受神经心理学测试的患者都有严重的记忆障碍，执行功能，和三个月的注意力，尽管没有基线认知障碍。结论。这些神志不清的重症监护病房患者的磁共振成像结果并未改变即时治疗过程，并且这些患者在三个月时出现神经心理障碍。未来的研究有必要确定当前和更新的磁共振成像技术在评估和管理重症监护病房患者中的作用。并检查院内磁共振成像结果(即白质高强度)与短期和长期神经系统结局之间的关系。
