Blanchette Marie, Pellerin Martin, Tremblay Luc, Lepage Martin, Fortin David
Department of Nuclear Medicine and Radiobiology, Université de Sherbrooke, Sherbrooke, Canada.
Neurosurgery. 2009 Aug;65(2):344-50; discussion 350-1. doi: 10.1227/01.NEU.0000349762.17256.9E.
Treatment of malignant gliomas is hampered by several factors, one of which is the blood-brain barrier (BBB). Thus, innovative strategies to cross the BBB have been developed, such as the BBB disruption procedure. Although it has been studied extensively, details regarding the physiology of the procedure remain obscure. This study was undertaken to clarify these issues.
Forty Wistar rats were imaged with a 7T animal magnetic resonance imaging scanner in dynamic acquisitions during BBB disruption. Gadolinium diethylenetriamine penta-acetic acid (Gd-DTPA) was injected to visualize and characterize the permeability of the BBB at different time points after disruption. The concentration of Gd-DTPA in the brain parenchyma was determined as a function of time after injection.
A typical pattern of signal change as a function of time was observed in the treated hemisphere of all animals. Initially, a slight signal decrease was observed in T1-weighted images followed by a strong increase corresponding to the injection of Gd-DTPA. Two different mechanisms seemed responsible for the distribution of Gd-DTPA within the parenchyma: 1) a direct diffuse increase in capillary permeability, and 2) a diffusion process in the interstitial compartment. Initial results showed that the barrier opens immediately after the procedure and for at least 30 minutes.
The methodology described in this article allows monitoring of the dynamics of the BBB disruption process and characterization of its physiology in vivo, and represents a marked advantage over postmortem static studies.
恶性胶质瘤的治疗受到多种因素的阻碍,其中之一是血脑屏障(BBB)。因此,已开发出创新的突破血脑屏障的策略,如血脑屏障破坏程序。尽管对此进行了广泛研究,但该程序的生理学细节仍不清楚。本研究旨在阐明这些问题。
40只Wistar大鼠在血脑屏障破坏过程中通过7T动物磁共振成像扫描仪进行动态采集成像。注射钆二乙烯三胺五乙酸(Gd-DTPA)以观察和表征破坏后不同时间点血脑屏障的通透性。测定脑实质中Gd-DTPA的浓度随注射后时间的变化。
在所有动物的治疗半球中观察到信号随时间变化的典型模式。最初,在T1加权图像中观察到轻微的信号下降,随后随着Gd-DTPA的注射出现强烈增加。两种不同的机制似乎负责Gd-DTPA在实质内的分布:1)毛细血管通透性的直接扩散增加,以及2)间质间隙中的扩散过程。初步结果表明,该程序后屏障立即打开并至少持续30分钟。
本文所述方法允许在体内监测血脑屏障破坏过程的动态并表征其生理学,与死后静态研究相比具有明显优势。