基于磁共振动态量化血脑屏障通透性的影像分析平台构建及其评价脑水肿的应用研究

How to quantitatively measure the permeability of blood－brain barrier in a noninvasive, objective and dynamic manner in vivo is still an unsolved problem. The difficulty is that there is lack of a comprehensive technology platform with appropriate research index to quantitatively measure the blood brain barrier, brain microstructure and microcirculation in an effective, accurate and dynamic manner. Based on the previous studies, the aim of this project is to construct a magnetic resonance image analysis platform to quantify the permeability of the blood brain barrier. The experimental traumatic brain edema, ischemic cerebral edema, hemorrhage brain edema in rabbit and mannitol treatment are used as the research object.　Then we use MRI technology and mean kurtosis (MK) and transmembrane transport coefficient (Ktrans) to detect the permeability of blood brain barrier and microcirculation microscopic structure.Meanwhile, various pathological examination results　combined with biomedical image analysis technology and post- processing software are used to select the appropriate key technical indicators.　Finally,　these appropriate key technical indicators were been used to quantitatively measure the permeability of blood brain barrier in patients with traumatic brain edema,　ischemic cerebral edema or hemorrhage cerebral edema. The evaluation of the permeability blood brain barrier through a noninvasive,　objective,　effective and practical multivariate MR analysis platform and image analysis technology is favourable to deepen the understanding of the mechanism of blood brain barrier opening, to guide treatment efficacy to evaluate the treatment efficacy, to predict prognosis.

如何在活体对血脑屏障的通透性进行无创、客观、动态的量化仍是一个未解决的问题，难点在于缺乏一个综合性技术平台以合适的观察指标对血脑屏障、脑微观结构和微循环进行有效、准确、动态和定量评价。本项目在前期研究基础上探讨构建基于磁共振的影像分析平台量化血脑屏障通透性。以兔创伤性脑水肿、缺血性脑水肿、出血性脑水肿模型及其甘露醇治疗为研究对象，利用MR技术及弥散丰度（MK）与跨膜转运系数（Ktrans）检测血脑屏障通透性与脑微观结构和微循环，以不同病理检查验证结果，结合生物医学影像分析技术及后处理软件，选择恰当的关键技术指标，应用于创伤性脑水肿、缺血性脑水肿、出血性脑水肿患者，量化血脑屏障通透性。构建评价血脑屏障通透性的无创客观有效实用的多因素MR技术分析平台和图像分析技术, 有利于深化血脑屏障开放机制的认识，对判断病情，指导治疗、评价疗效及预后，药物通过血脑屏障研究，具有重要的临床实用价值。

血脑屏障是机体维持脑和神经系统实施正常功能的重要结构基础，血脑屏障破坏在脑水肿的形成过程中起着重要作用。本项目以脑外伤为切入点、应用磁共振新序列，在活体对血脑屏障的通透性进行无创、客观、动态的定量评价，并将该技术应用于脑水肿治疗、脑外伤患者预后评价当中, 有利于深化血脑屏障开放机制的认识, 对判断病情, 指导治疗、评价疗效及预后, 药物通过血脑屏障研究, 具有重要的临床实用价值。主要完成了以下任务（1）进一步完善了磁共振DCE序列和DKI序列参数设置；（2）应用磁共振DCE序列评价高压氧在治疗脑外伤脑水肿中的作用；（3）应用磁共振DCE序列评价脑外伤后20-HETE及其抑制剂影响血脑屏障的实验研究；（4）应用小动物7T磁共振DKI评价脑外伤不同时间点参数改变以评价血脑屏障破坏规律；（5）应用磁共振多序列包括DKI序列、SWI序列、T1MPRAGE序列评价脑外伤患者预后中的作用。已发表论文14篇，其中SCI收录9篇，毕业研究生3名。