基于加多和水的血脑屏障功能障碍措施,用于偶发性小血管疾病患者
Michael S Stringer1,2, Xingfeng Shao3, Hedok Lee4
1Centre for Clinical Brain Sciences and UK Dementia Research Institute, University of Edinburgh, Edinburgh, United Kingdom.
扩散权重动脉旋转标签 (DW-ASL) 测量了小血管疾病 (SVD) 中的血脑屏障 (BBB) 水交换率 (kw). 较高的kW与SVD负担和进展相关,但与基于加多的对比剂 (GBCA) 的测量不同.
科学领域:
- 神经学 神经学
- 放射学 放射学是一门学科.
- 生物物理学的生物物理.
背景情况:
- 小血管疾病 (SVD) 与微妙的血脑屏障 (BBB) 泄漏有关.
- 基于加多的对比剂 (GBCA) 是为BBB评估而建立的,但扩散权重动脉旋转标签 (DW-ASL) 通过测量水交换率 (kW) 提供了无对比的替代方案.
- 在零星SVD中DW-ASL的实用性需要进一步调查.
研究的目的:
- 评估DW-ASL衍生的kW与GBCA测量的BBB泄漏在SVD患者之间的关系.
- 确定 kw 与基线 SVD 负担及其 1 年变化之间的相关性.
主要方法:
- 招募了轻度缺血性中风和SVD特征的患者.
- 使用DW-ASL评估了kw.
- 使用动态对比增强的MRI与GBCA (测量透率-表面积产物,血体积和GBCA交换率) 来量化BBB泄漏.
- 采用线性回归来分析kW,GBCA指标和白质超强度 (WMH) 体积变化之间的关联.
主要成果:
- 较高的kW值与较大的基线SVD负担相关 (例如,皮下灰质:B=14.59分钟-1%WMH体积,p=0.04) 和WMH体积在1年内增加 (B=0.0013%WMH体积增加/min-1,p=0.06).
- 在kW和GBCA衍生的BBB泄漏量之间没有发现显著的关联 (例如,SGM kw~PS:B=-0.23 min−1/10−4 min−1,p=0.95).
结论:
- 导出DW-ASL的BBB水交换 (kw) 可能作为SVD中BBB功能障碍的敏感指标,与白质超强度负担和进展相关.
- 由于DW-ASL和GBCA指标之间缺乏一致性,这表明这些方法捕捉了BBB生理学的不同方面.
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