无创性影像技术在缺血性脑卒中血脑屏障通透性评估方面的应用进展

Application progress of non-invasive imaging technology in assessment of blood brain barrier permeability in ischemic stroke

血脑屏障是中枢神经系统调节分子和细胞进出的主要结构,血脑屏障能够保护脑组织免受毒素的侵害,促进物质运输,并维持离子平衡。缺血性脑卒中(IS)具有高发病率、高复发率以及高致死致残率等特点,基于梗死核心区域内血脑屏障结构以及功能受到破坏、通透性增高的特点,无创性评估血脑屏障结构功能的影像学检查方法包括动态对比增强磁共振成像(DCE-MRI)、CT灌注成像(CTP)、动脉自旋标记(ASL)成像等,ASL技术具有无创、安全、便捷等特点,受到临床广泛关注。本文就无创性影像检查技术,特别是ASL技术在缺血性脑血管病血脑屏障评估中的临床应用进展进行综述。

The blood brain barrier(BBB)is the main structure of the central nervous system that regulates the entry and exit of molecules and cells.BBB can protect brain tissues from toxins,promote the material transport,and maintain the ion balance.Ischemic stroke(IS)is characterized by high incidence rate,high recurrence rate,and high mortality and disability rate.Based on the characteristics of BBB structure and function damaged and permeability increased in the core area of infarction,the imaging methods for non-invasive assessment of BBB structure and function include:magnetic resonance dynamic contrast enhanced imaging(DCE-MRI),CT perfusion imaging(CTP),magnetic resonance arterial spin labeling(ASL)sequence,etc.The ASL is non-invasive,safe,and convenience,and has attracted extensive clinical attention.This article reviews the clinical application of non-invasive imaging techniques,especially ASL,in BBB assessment of ischemic cerebrovascular disease.