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急性脊髓损伤患者治疗的临床操作指南:关于MRI基线在临床治疗决策与结果预测中作用的几点建议（英文）

中华神经外科疾病研究杂志 2017年第6期16卷 529-529页

作者： Fehlings MG Martin AR tetreault LA Aarabi B Anderson P Arnold PM Brodke D Burns As Chiba K Dettori JR Furlan JC Hawryluk G Holly Lt howley s.jeji t Kalsi-Ryan s Kotter M Kurpad s Kwon BK Marino RJ Massicotte E Merli G Middleton JW Nakashima H Nagoshi N Palmieri K singh A skelly AC tsai EC Vaccaro A Wilson JR Yee A Harrop Js toronto Western Hospital University Health Network University of toronto University College Cork University of Maryland University of Wisconsin University of Kansas Medical Center The University of Kansas University of Utah toronto Rehabilitation Institute University Health Network National Defense Medical College spectrum Research Inc University of California at Los Angeles Christopher & Dana Reeve Foundation Ontario Neurotrauma Foundation University of Cambridge Medical College of Wisconsin University of British Columbia thomas Jefferson University Hospital University of sydney Nagoya University Keio University the University of Kansas Ottawa Hospital Research Institute thomas Jefferson University Li Ka shing Knowledge Institute St. Michael's Hospital sunnybrook Health sciences Centre

the objective of this guideline is to outline the role of magnetic resonance imaging(MRI) in clinical decision making and outcome prediction in patients with traumatic spinal cord injury(sCI).Methods A systematic review of the literature was conducted to address key questions related to the use of MRI in patients with traumatic *** review focused on longitudinal studies that controlled for baseline neurologic status.A multidisciplinary Guideline Development Group(GDG) used this information,their clinical expertise,and patient input to develop recommendations on the use of MRI for sCI *** on GRADE(Grading of Recommendation,Assessment,Development and Evaluation),a strong recommendation is worded as " we recommend," whereas a weaker recommendation is indicated by "we suggest." Results Based on the limited available evidence and the clinical expertise of the GDG,our recommendations were:(1) "We suggest that MRI be performed in adult patients with acute sCI prior to surgical intervention,when feasible,to facilitate improved clinical decision-making"(quality of evidence,very low) and(2) "We suggest that MRI should be performed in adult patients in the acute period following sCI,before or after surgical intervention,to improve prediction of neurologic outcome "(quality of evidence,low).Conclusions these guidelines should be implemented into clinical practice to improve outcomes and prognostication for patients with sCI.

关键词：神经外科疾病医学研究患者

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