摘要
随着全球老龄化进程加速,有关阿尔茨海默病(Alzheimer's disease,AD)的病理机制研究成为神经科学领域的核心议题。胶质淋巴系统(glymphatic system,GS)作为中枢神经系统的代谢废物清除网络,其功能障碍与AD的β-淀粉样蛋白(amyloid-beta,Aβ)沉积及Tau蛋白病理密切相关。可视化GS早期结构与功能的改变对于相关的神经退行性疾病的早期诊断以及开发新的治疗方案的开发有着重要的意义。近年来,多模态磁共振成像(magnetic resonance imaging,MRI)技术如:动态对比增强MRI(dynamic contrast enhanced MRI,DCE-MRI)、沿血管周围间隙扩散张量成像分析(diffusion tensor imaging analysis along the perivascular space,DTI-ALPS)、化学交换饱和转移成像(chemical-exchange-saturation-transfer MRI,CEST-MRI)以及静息态功能磁共振成像(resting state functional MRI,rs-fMRI)通过无创或微创方式逐步实现了GS结构与功能的可视化。本文综述了临床前与临床研究证据,并探讨了如何借助多模态MRI技术动态监测GS功能变化及其流入流出途径,以诊断及预测AD进展,试图阐明GS功能障碍可视化证据及寻找相关神经影像标志物,从而对AD早期诊断及病理机制提供新思路。
With the acceleration of global aging,research on the pathogenesis of Alzheimer's disease(AD)has become a central issue in neuroscience.The glymphatic system(GS),a perivascular network responsible for the clearance of metabolic waste in the central nervous system,plays a key role in the accumulation of amyloid-beta(Aβ)and Tau pathology associated with AD.Early visualization of structural and functional changes in GS is important to diagnose some of the neurodegenerative diseases and develop new therapeutic options.In recent years,multimodal magnetic resonance imaging(MRI)techniques—including dynamic contrast-enhanced MRI(DCE-MRI),diffusion tensor imaging analysis along the perivascular space(DTI-ALPS),chemical-exchange-saturation-transfer MRI(CEST-MRI),and resting state functional MRI(rs-fMRI)—have gradually visualized the structure and function of GS in a noninvasive or minimally invasive way.In this paper,we review the preclinical and clinical research evidence and dynamically monitor the GS functional changes and influx-efflux pathways using multimodal MRI technology.By elucidating visualized evidence of GS dysfunction and identifying associated neuroimaging biomarkers,this work aims to provide novel insights into early AD diagnosis and the underlying pathological mechanisms.
作者
胡玉馨
苏云燕
姚辉
杨义文
严所钰
HU Yuxin;SU Yunyan;YAO Hui;YANG Yiwen;YAN Suoyu(Department of Radiology,the First Affiliated Hospital of Soochow University,Suzhou 215006,China;Department of General Surgery,the First Affiliated Hospital of Soochow University,Suzhou 215006,China)
出处
《磁共振成像》
北大核心
2025年第7期109-116,共8页
Chinese Journal of Magnetic Resonance Imaging
基金
国家自然科学基金项目(编号:81701667)
江苏省青年科技人才托举工程项目(编号:TJ-2023-028)
苏州市卫生青年骨干人才“全国导师制项目”(编号:Qngg2024001)。
关键词
阿尔茨海默病
胶质淋巴系统
磁共振成像
沿血管周围间隙扩散张量成像分析
Alzheimer's disease
glymphatic system
magnetic resonance imaging
diffusion tensor imaging analysis along the perivascular space
