动脉自旋标记技术在急性脑梗死中的应用进展  

Application progress of arterial spin labeling technique in acute cerebral infarction

作　　者：侯聪 侯姗姗 张俊[1] 李启霖 刘新疆[1,3] HOU Cong;HOU Shanshan;ZHANG Jun;LI Qilin;LIU Xinjiang(Department of Radiology,Affiliated Hospital of Binzhou Medical University,Binzhou 256603,China;Weifang Medical University,Weifang 261000,China;Department of Radiology,Shanghai Pudong Hospital(Fudan University Pudong Medical Center),Shanghai 201399,China)

机构地区：[1]滨州医学院附属医院放射科,山东滨州256603 [2]潍坊医学院,山东潍坊261000 [3]上海市浦东医院(复旦大学附属浦东医院)放射科,上海201399

出　　处：《分子影像学杂志》2020年第4期563-567,共5页Journal of Molecular Imaging

基　　金：上海市浦东新区卫生健康委2020年度卫生科技项目(PW2020A-35);山东省自然科学基金计划(ZR2016HL43);山东省医药卫生科技发展计(2015WS0479)。

摘　　要：动脉自旋标记(ASL)技术是通过标记动脉血中的氢质子来测量脑血流的灌注情况进行灌注评估的检查方法,是一种绝对定量灌注,不仅可以生成灌注图像进行定性判断,还可定量计算出灌注的特征性参数,即脑血流量。3D-ASL具备快速成像、灌注均匀、高信噪比、低SAR值等特质,目前是ASL白皮书中最推荐使用的灌注技术。供血区ASL作为新出现的ASL衍生技术,能够选择兴趣动脉进行标记,得到兴趣动脉供血区域的灌注图像及相应脑区的脑血流值,在评估脑血管疾病患者的侧支循环建立情况具有重大意义。因此ASL目前被广泛应用于神经系统疾病的研究。急性脑梗死(ACI)是由多种原因引起的(如脑动脉硬化血栓形成、大动脉炎等)血管全部或不全闭塞,导致中枢神经系统急性缺血、缺氧继而引发组织缺血坏死,并产生不良后果的疾病。ACI最有效的治疗包括溶栓、取栓等进而达到缺血区域再灌注的目的,希望能够扩大治疗时间窗,尽可能拯救非核心梗死区的组织,因此临床对急性缺血性脑卒中的多模态影像学检查,包括更早期发现异常脑血流灌注,评估灌注减低程度、范围及病变血管,具有更高的期待。随着近些年来大量的研究表明,ASL及其衍生技术在这些方面体现出了巨大的价值。本文对ASL的成像原理与衍生技术、ASL在ACI中的应用进展及ASL在ACI疾病应用的优势与不足予以综述。Arterial spin labeling(ASL)is an absolute quantitative perfusion method that measures the perfusion of cerebral blood flow by labeling hydrogen protons in arterial blood for perfusion assessment.It can not only generate perfusion images for qualitative judgment,but also quantitatively calculate the characteristic parameters of perfusion,that is,cerebral blood flow.3D-ASL features fast imaging,perfusion uniformity,high signal-to-noise ratio,low SAR value,and is currently the most recommended perfusion technique in ASL white papers.As a new ASL-derived technology,TASL in blood supply area can select the artery of interest for labeling,obtain the perfusion image of the artery of interest supply area,and obtain the cerebral blood flow of the corresponding brain area,which is of great significance in evaluating the establishment of collateral circulation in patients with cerebrovascular diseases.ASL is therefore currently widely used in the study of neurological diseases.Acute cerebral infarction(ACI)is a disease caused by various reasons(such as cerebral arteriosclerosis thrombosis,Takayasu arteritis,etc.),resulting in acute ischemia and hypoxia of the central nervous system followed by tissue ischemic necrosis,and adverse consequences.The most effective treatment of ACI includes thrombolysis,embolectomy,etc.,so as to achieve the purpose of reperfusion in the ischemic area,hoping to expand the treatment time window and save the tissue in the non-core infarct area as much as possible.Therefore,clinical multi-modal imaging examination of acute ischemic stroke,including earlier detection of abnormal cerebral blood flow perfusion,assessment of the degree and extent of perfusion reduction and diseased vessels,has a higher expectation.With a large number of studies in recent years,ASL and its derivative technology have shown great value in these aspects.This article reviews the imaging principle and derivative technology of ASL,the application progress of ASL in ACI and the advantages and disadvantages of ASL in ACI diseas

关 键 词：动脉自旋标记 MR灌注成像 3D-ASL TASL 急性脑梗死 脑血流量 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743.33[医药卫生—诊断学]