动脉自旋标记磁共振灌注技术在脑血管病中的应用进展

动脉自旋标记(arterial spin labeling,ASL)技术是利用自身动脉血内可自由弥散的水质子作为内源性示踪剂来完成脑灌注评价的一种功能磁共振成像(magnetic resonance imaging,MRI)技术。在短暂性脑缺血发作中,ASL可以敏感地发现脑灌注的异常;在急性脑梗死中,ASL技术可以用来评估缺血半暗带、识别供血动脉闭塞、发现梗死灶周围的高灌注以及评估侧支循环;在慢性脑血管病中,多期ASL技术可以较准确地评估脑血流量、双期ASL技术可以定量评估侧支循环,另外,ASL还可用来评估脑血流储备;在烟雾病中,ASL技术可以评估烟雾病术前和术后的灌注情况以及侧支循环;在脑小血管病、脑血管畸形及可逆性后部脑病中,ASL也有一定的应用。最后介绍了ASL技术的局限性及未来的发展前景。

Application and development of arterial spin labeling technique of magnetic resonance imaging in cerebrovascular disease

Arterial spin labeling (ASL) is a functional MRI technique that can noninvasively assess cerebral blood flow using blood as an endogenous contrast agent. In this article, the clinical application of ASL technology in cerebrovascular disease will be reviewed. In transient ischemic attack, ASL can be sensitive to the brain perfusion abnormalities. In acute cerebral infarction, ASL can be used to assess ischemic penumbra, identify arterial occlusion of the arteries, and detect high perfusion around the infarct area. In the chronic cerebrovascular disease, multi-ASL technique can assess cerebral blood flow more accurately than before; two-stage ASL technology can assess collateral blood vessels quantitatively, also ASL can be used to assess cerebrovascular reserve. In moyamoya disease, ASL technology can assess the preoperative and postoperative perfusion and collateral blood vessels. The final statement is about ASL technology in cerebrovascular malformations and reversible posterior encephalopathy application. In the final part, current limitations and future developments of ASL techniques will be reviewed.