Noncardiac surgery conveys a substantial risk of secondary organ dysfunction and injury. Neurocognitive dysfunction and covert stroke are emerging as major forms of perioperative organ dysfunction, but a better understanding of perioperative neurobiology is required to identify effective treatment strategies. The likelihood and severity of perioperative brain injury may be increased by intraoperative hemodynamic dysfunction, tissue hypoperfusion, and a failure to recognize complications early in their development. Advances in neuroimaging and monitoring techniques, including optical, sonographic, and magnetic resonance, have progressed beyond structural imaging and now enable noninvasive assessment of cerebral perfusion, vascular reserve, metabolism, and neurologic function at the bedside. Translation of these imaging methods into the perioperative setting has highlighted several potential avenues to optimize tissue perfusion and deliver neuroprotection. This review introduces the methods, metrics, and evidence underlying emerging optical and magnetic resonance neuroimaging methods and discusses their potential experimental and clinical utility in the setting of noncardiac surgery.

中文翻译：

---

神经影像学和监测在非心脏手术中保护脑灌注的进展。

非心脏手术带来了继发性器官功能障碍和损伤的重大风险。神经认知功能障碍和隐性中风正在成为围手术期器官功能障碍的主要形式，但需要更好地了解围手术期神经生物学以确定有效的治疗策略。围手术期脑损伤的可能性和严重程度可能会因术中血流动力学功能障碍、组织灌注不足以及未能在其发展早期识别并发症而增加。神经影像学和监测技术的进步，包括光学、超声和磁共振，已经超越了结构成像，现在可以在床边对脑灌注、血管储备、代谢和神经功能进行无创评估。将这些成像方法转化为围手术期环境突出了优化组织灌注和提供神经保护的几种潜在途径。这篇综述介绍了新兴的光学和磁共振神经影像学方法的方法、指标和证据，并讨论了它们在非心脏手术中的潜在实验和临床效用。