脓毒症患者的急性脑磁共振成像异常。

IF 3.6 3区 医学 Q2 CLINICAL NEUROLOGY
Neurocritical Care Pub Date : 2025-10-01 Epub Date: 2025-04-28 DOI:10.1007/s12028-025-02235-y
Toru Hosokawa, Kosaku Kinoshita, Shingo Ihara, Katsuhiro Nakagawa, Umefumi Iguchi, Tomokazu Mutoh, Nami Sawada, Tsukasa Kuwana, Junko Yamaguchi, Atsushi Sakurai
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引用次数: 0

摘要

背景:脓毒症通常与脑损伤共同发展,脓毒症相关脑损伤的机制已被阐明。然而,仅有少数研究报道了脓毒症脑损伤的诊断性影像学评估。因此,在本研究中,我们分析了败血症患者的脑磁共振(MR)成像(MRI)结果。方法:这项单中心前瞻性观察性研究包括71例败血症患者,无论是否存在休克和急性神经异常,均接受脑MRI检查。磁共振图像根据有无急性脑缺血和脑白质病进行分类,正常表现表明两种情况都没有。结果:18例(25.3%)患者mri表现为急性脑缺血和脑白质病变。仅有白质脑病44例(62.0%)。在患者人口学特征和神经预后方面,急性脑缺血患者、脑白质病变患者和无急性脑缺血患者之间存在显著差异。两组患者在年龄(P = 0.0296)、神经学表现(P = 0.0057)、重症监护天数(P = 0.0239)、住院期间急性弥散性血管内凝血评分(P = 0.0363)、出院或转院时Katz指数(P = 0.0020)等方面均存在显著差异。结论:在脓毒症患者中,无论病情严重程度如何,25.3%的患者在脑MRI上表现为急性脑缺血,包括缺氧和低血压,以及是否存在休克。在无急性脑功能障碍的患者中也观察到异常的MRI结果。重要的是,异常的脑MRI结果与较差的神经预后相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Acute Abnormalities Identified on Brain Magnetic Resonance Imaging in Patients with Sepsis.

Background: Sepsis often codevelops with brain damage, and the mechanisms underlying sepsis-related brain damage have been elucidated. However, only a few studies have reported the diagnostic imaging assessments for brain damage in sepsis. Therefore, in this study, we analyzed the brain magnetic resonance (MR) imaging (MRI) findings of patients with sepsis.

Methods: This single-center prospective observational study included 71 patients with sepsis who underwent brain MRI, regardless of the presence or absence of shocks and acute neurological abnormalities. The MR images were classified according to the presence or absence of acute cerebral ischemia and leukoencephalopathy, with normal findings indicating neither condition.

Results: The MR images of 18 patients (25.3%) showed acute cerebral ischemia and leukoencephalopathy. Furthermore, 44 patients (62.0%) had only leukoencephalopathy. In terms of patient demographic characteristics and neurological outcomes, significant differences were noted among patients with acute cerebral ischemia findings, those with leukoencephalopathy findings, and those with neither. There were significant differences in age (P = 0.0296), neurological findings (P = 0.0057), number of days in the intensive care unit (P = 0.0239), acute disseminated intravascular coagulation score during hospitalization (P = 0.0363), and the Katz index at discharge or transfer (P = 0.0020) among these groups.

Conclusions: Among patients with sepsis, 25.3% showed acute cerebral ischemia findings on brain MRI, regardless of illness severity, including hypoxia and hypotension, and presence of shock. Abnormal MRI findings were also observed in patients without acute brain dysfunction. Importantly, abnormal brain MRI findings were associated with worse neurological outcomes.

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来源期刊
Neurocritical Care
Neurocritical Care 医学-临床神经学
CiteScore
7.40
自引率
8.60%
发文量
221
审稿时长
4-8 weeks
期刊介绍: Neurocritical Care is a peer reviewed scientific publication whose major goal is to disseminate new knowledge on all aspects of acute neurological care. It is directed towards neurosurgeons, neuro-intensivists, neurologists, anesthesiologists, emergency physicians, and critical care nurses treating patients with urgent neurologic disorders. These are conditions that may potentially evolve rapidly and could need immediate medical or surgical intervention. Neurocritical Care provides a comprehensive overview of current developments in intensive care neurology, neurosurgery and neuroanesthesia and includes information about new therapeutic avenues and technological innovations. Neurocritical Care is the official journal of the Neurocritical Care Society.
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