疾病控制和预防中心(CDC)的2018年儿科轻度创伤性脑损伤(mTBI;在此也称为脑震荡)的现行做法指南,根据当前证据系统地确定了最佳的最新做法,具体来说,已确定有关计算机断层扫描(CT)的推荐做法,磁共振成像(MRI),和颅骨X光片成像.在这篇文章中,我们讨论了指南中没有讨论的神经影像学类型对儿科人群的安全性,其潜在的应用,以及调查未来使用某些模式来辅助儿童mTBI诊断和治疗的研究。神经影像学在儿童mTBI病例中的作用应被认为是对儿童神经和社会发展的潜在贡献,除了直接的临床价值(如急性结构发现)。在研究中选择性使用特定的神经影像学模式已经被证明可以检测弥漫性脑损伤的各个方面,大脑血流中断,并将生理因素与持续性症状相关联,比如疲劳,认知能力下降,头痛,和情绪变化,跟随mTBI。然而,这些先进的神经成像模式目前仅限于研究领域,和任何未来的临床应用先进的成像模式在儿科mTBI将需要强有力的证据,每种模式的能力,以提供大脑发育的微妙条件的测量,疾病,损坏,或者退化,同时考虑非损伤和损伤后时间的变量。研究人员和医疗保健提供者之间的持续合作和沟通对于调查至关重要,发展,并验证先进的成像模式在儿科mTBI诊断和管理中的潜力。
The Center for Disease Control and Prevention (CDC)\'s 2018
Guideline for current practices in pediatric mild traumatic brain injury (mTBI; also referred to as concussion herein) systematically identified the best up-to-date practices based on current evidence and, specifically, identified recommended practices regarding computed tomography (CT), magnetic resonance imaging (MRI), and skull radiograph imaging. In this article, we discuss types of neuroimaging not discussed in the
guideline in terms of their safety for pediatric populations, their potential application, and the research investigating the future use of certain modalities to aid in the diagnosis and treatment of mTBI in children. The role of neuroimaging in pediatric mTBI cases should be considered for the potential contribution to children\'s neural and social development, in addition to the immediate clinical value (as in the case of acute structural findings). Selective use of specific neuroimaging modalities in research has already been shown to detect aspects of diffuse brain injury, disrupted cerebral blood flow, and correlate physiological factors with persistent symptoms, such as fatigue, cognitive decline, headache, and mood changes, following mTBI. However, these advanced neuroimaging modalities are currently limited to the research arena, and any future clinical application of advanced imaging modalities in pediatric mTBI will require robust evidence for each modality\'s ability to provide measurement of the subtle conditions of brain development, disease, damage, or degeneration, while accounting for variables at both non-injury and time-post-injury epochs. Continued collaboration and communication between researchers and healthcare providers is essential to investigate, develop, and validate the potential of advanced imaging modalities in pediatric mTBI diagnostics and management.