Modern neurocritical care relies on ancillary diagnostic testing in the form of multimodal monitoring to address acute changes in the neurological homeostasis. Much of our armamentarium rests upon physiological and biochemical surrogates of organ or regional level metabolic activity, of which a great deal is invested at the metabolic–hemodynamic–hydrodynamic interface to rectify the traditional intermediaries of glucose consumption. Despite best efforts to detect cellular neuroenergetics, current modalities cannot appreciate the intricate coupling between astrocytes and neurons. Invasive monitoring is not without surgical complication, and noninvasive strategies do not provide an adequate spatial or temporal resolution. Without knowledge of the brain’s versatile behavior in specific metabolic states (glycolytic vs oxidative), clinical practice would lag behind laboratory empiricism. Noninvasive metabolic imaging represents a new hope in delineating cellular, nigh molecular level energy exchange to guide targeted management in a diverse array of neuropathology.

中文翻译：

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影像学治疗指导：神经能量学的黎明。

现代神经重症监护依靠多模式监测形式的辅助诊断测试来解决神经动态平衡的急性变化。我们的许多武器库都依靠器官或区域水平代谢活动的生理和生化指标，其中大量投入在代谢-血液动力学-流体动力学界面上，以纠正传统的葡萄糖消耗媒介。尽管尽了最大努力来检测细胞神经能量学，但目前的方法尚不能理解星形胶质细胞与神经元之间的复杂耦合。侵入式监测并非没有手术并发症，并且非侵入性策略无法提供足够的空间或时间分辨率。不了解特定代谢状态下大脑的通用行为（糖酵解与氧化性），临床实践将落后于实验室经验。非侵入性代谢成像代表了描绘细胞，近分子水平能量交换以指导多种神经病理学中靶向治疗的新希望。