颅脑计算机断层扫描 (CT) 扫描是排除小儿创伤性脑损伤 (TBI) 后颅内病变最广泛使用的工具。然而，在儿科人群中，辐射暴露可能导致血液和脑肿瘤的风险增加。 2019 年国家健康与护理卓越研究所 (NICE) 指南将血清生物标志物测量（特别是 S100B）定义为“大脑肌钙蛋白”，由于其能够预测颅内后遗症，已逐渐成为 TBI 管理的补充工具。该系统评价是按照 PRISMA 协议（系统评价和荟萃分析的首选报告项目）进行的。不包括研究出版物的时间顺序限制。研究报告了 TBI 儿童接受血清 S100B 测量和计算机断层扫描 (CT) 扫描的数据。在筛选的 380 篇文章中，10 篇研究符合纳入标准。急诊科 (ED) 收治的轻度 TBI 患者为 1325 名 (80.25%)。总体汇总敏感性和特异性分别为 98% (95% CI, 92-99%) 和 45% (95% CI, 29-63%)。荟萃分析显示较高的阴性预测值 (NVP)（99%；95% CI，94-100%）和较低的阳性预测值（PPV）（41%；95% CI，16-79%）。曲线下面积 (AUC) 为 76% (95% CI, 65-85%)。总体汇总阴性预测值 (NPV) 为 99%（95% CI，99-100%）。在 mTBI 诊断工作流程中测量血清 S100B 有助于在 ED 环境中做出明智的决策，从而可能安全地减少使用CT 扫描在儿科人群中的应用。高灵敏度和出色的阴性预测值看起来很有希望，并且似乎接近成人的值。尽管如此，必须指出研究中发现的高度异质性（>90%）。为了将 S100B 定期引入儿科 TBI 工作流程中，重要的是进行进一步研究，以获得基于儿科参考区间的截止水平。© 2024。作者。

Cranial computed tomography (CT) scan is the most widely used tool to rule out intracranial lesions after pediatric traumatic brain injury (TBI). However, in pediatric population, the radiation exposure can lead to an increased risk of hematological and brain neoplasm. Defined in 2019 National Institute for Health and Care Excellence (NICE) guidelines as "troponins for the brain", serum biomarkers measurements, particularly S100B, have progressively emerged as a supplementary tool in the management of TBI thanks to their capacity to predict intracranial post-traumatic lesions.This systematic review was conducted following the PRISMA protocol (preferred reporting items for systematic reviews and meta-analyses). No chronological limits of study publications were included. Studies reporting data from children with TBI undergoing serum S100B measurement and computed tomography (CT) scans were included.Of 380 articles screened, 10 studies met the inclusion criteria. Patients admitted with mild-TBI in the Emergency Department (ED) were 1325 (80.25%). The overall pooled sensitivity and specificity were 98% (95% CI, 92-99%) and 45% (95% CI, 29-63%), respectively. The meta-analysis revealed a high negative predictive value (NVP) (99%; 95% CI, 94-100%) and a low positive predictive value (PPV) (41%; 95% CI, 16-79%). Area under the curve (AUC) was 76% (95% CI, 65-85%). The overall pooled negative predictive value (NPV) was 99% (95% CI, 99-100%).The measurement of serum S100B in the diagnostic workflow of mTBI could help informed decision-making in the ED setting, potentially safely reducing the use of CT scan in the pediatric population. The high sensitivity and excellent negative predictive values look promising and seem to be close to the values found in adults. Despite this, it must be pointed out the high heterogeneity (> 90%) found among studies. In order for S100B to be regularly introduced in the pediatric workflow for TBI, it is important to conduct further studies to obtain cut-off levels based on pediatric reference intervals.© 2024. The Author(s).