Use of dynamic contrast-enhanced MRI to measure subtle blood-brain barrier abnormalities
Use of dynamic contrast-enhanced MRI to measure subtle blood-brain barrier abnormalities
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DOI：
10.1016/j.mri.2010.09.002
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发表时间：
2011-04-01
影响因子：
2.5
通讯作者：
Wardlaw, Joanna M.
中科院分区：
文献类型：
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作者：
Armitage, Paul A.;Farrall, Andrew J.;Wardlaw, Joanna M.
人们越来越有兴趣研究血脑屏障（BBB）功能的微妙变化在常见神经系统疾病中的作用，以及使用成像技术来评估这些异常的可能性。一些研究使用了动态对比增强磁共振成像 (DCE-MRI)，这些研究表明，与该技术的传统应用（例如颅内肿瘤和多发性硬化症）相比，信号变化要小得多。在这项工作中，根据可见的潜在白质异常程度对轻度中风患者进行了 DCE-MRI 研究，得出了初步结果。这些数据用于估计不同组织类型中的典型信号增强概况以及白质异常的程度。还研究了扫描仪噪声、漂移和不同的固有组织特性对信号增强数据的影响，并讨论了解释增强曲线的可能含义。在不同程度白质异常的患者之间，平均信号增强或造影剂浓度没有观察到显着差异，尽管白质异常越多，信号增强越大的趋势。此外，结果表明，许多考虑的因素引入了与预期效应大小类似的不确定性，从而不清楚信号增强的差异是否真正反映了潜在的 BBB 异常或由于不相关的效应。由于最终目标是实现对细微疾病中 BBB 功能的可靠量化，因此本研究强调了可能影响信号增强的因素，并表明需要进一步开展工作来解决量化健康和患病活人体组织中造影剂浓度以及建立合适的模型以量化相关生理参数的挑战性问题。同时，未来的研究必须使用适当的对照组来尽量减少这些影响。 (C) 2011 Elsevier Inc. 保留所有权利。
There is growing interest in investigating the role of subtle changes in blood-brain barrier (BBB) function in common neurological disorders and the possible use of imaging techniques to assess these abnormalities. Some studies have used dynamic contrast-enhanced MR imaging (DCE-MRI) and these have demonstrated much smaller signal changes than obtained from more traditional applications of the technique, such as in intracranial tumors and multiple sclerosis. In this work, preliminary results are presented from a DCE-MRI study of patients with mild stroke classified according to the extent of visible underlying white matter abnormalities. These data are used to estimate typical signal enhancement profiles in different tissue types and by degrees of white matter abnormality. The effect of scanner noise, drift and different intrinsic tissue properties on signal enhancement data is also investigated and the likely implications for interpreting the enhancement profiles are discussed. No significant differences in average signal enhancement or contrast agent concentration were observed between patients with different degrees of white matter abnormality, although there was a trend towards greater signal enhancement with more abnormal white matter. Furthermore, the results suggest that many of the factors considered introduce uncertainty of a similar magnitude to expected effect sizes, making it unclear whether differences in signal enhancement are truly reflective of an underlying BBB abnormality or due to an unrelated effect. As the ultimate aim is to achieve a reliable quantification of BBB function in subtle disorders, this study highlights the factors which may influence signal enhancement and suggests that further work is required to address the challenging problems of quantifying contrast agent concentration in healthy and diseased living human tissue and of establishing a suitable model to enable quantification of relevant physiological parameters. Meanwhile, it is essential that future studies use an appropriate control group to minimize these influences. (C) 2011 Elsevier Inc. All rights reserved.