Quantitative measurement of blood-brain barrier permeability in human using dynamic contrast-enhanced MRI with fast T1 mapping.
Quantitative measurement of blood-brain barrier permeability in human using dynamic contrast-enhanced MRI with fast T1 mapping.
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DOI：
10.1002/mrm.22686
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发表时间：
2011-04
影响因子：
3.3
通讯作者：
Rosenberg GA
中科院分区：
文献类型：
--
作者：
Taheri S;Gasparovic C;Shah NJ;Rosenberg GA
血脑屏障(BBB)的破坏存在于许多神经系统疾病中，在人类中很难进行非侵入性测量。动态对比增强磁共振成像测量血脑屏障通透性。然而，重大的技术挑战依然存在，缺乏来自健康人的规范数据。我们报告了一种测量血脑屏障通透性的方法的实施，该方法最初是在动物中开发的，用于评估健康受试者和白质病理患者的血脑屏障通透性。用快速T1图测量造影剂Gd-DTPA从血浆到脑内的漏出量。动态增强磁共振成像的标准Gd-DTPA剂量的四分之一被发现既能提供足够的对比度与噪声，又能提供高T1灵敏度。使用Patlak图解方法根据1/t1的变化计算渗透率。将通透性常数与脑脊液白蛋白指数进行比较。正常人脑白质血脑屏障通透性的95%可信区间上限为3×10−4 L/gmin。在接受腰椎穿刺术的受试者中，MRI测量结果与脑脊液白蛋白水平密切相关。使用低剂量Gd-DTPA和快速T1成像的动态对比增强磁共振成像是测量人体血脑屏障通透性细微差异的一种敏感方法，可能比单纯基于像素对比度变化的测量技术具有优势。
Breakdown of the blood-brain barrier (BBB), occurring in many neurological diseases, has been difficult to measure noninvasively in humans. Dynamic contrast-enhanced magnetic resonance imaging measures BBB permeability. However, important technical challenges remain and normative data from healthy humans is lacking. We report the implementation of a method for measuring BBB permeability, originally developed in animals, to estimate BBB permeability in both healthy subjects and patients with white matter pathology. Fast T1 mapping was used to measure the leakage of contrast agent Gadolinium diethylene triamine pentaacetic acid (Gd-DTPA) from plasma into brain. A quarter of the standard Gd-DTPA dose for dynamic contrast-enhanced magnetic resonance imaging was found to give both sufficient contrast-to-noise and high T1 sensitivity. The Patlak graphical approach was used to calculate the permeability from changes in 1/T1. Permeability constants were compared with cerebrospinal fluid albumin index. The upper limit of the 95% confidence interval for white matter BBB permeability for normal subjects was 3 × 10−4 L/g min. MRI measurements correlated strongly with levels of cerebrospinal fluid albumin in those subjects undergoing lumbar puncture. Dynamic contrast-enhanced magnetic resonance imaging with low dose Gd-DTPA and fast T1 imaging is a sensitive method to measure subtle differences in BBB permeability in humans and may have advantages over techniques based purely on the measurement of pixel contrast changes.