Department of Neurology, Universitätsklinikum Mannheim, University of Heidelberg, Germany.
Curr Pharm Des. 2012;18(15):2223-35. doi: 10.2174/138161212800099982.
Rapid advances in microbubble pharmacology together with novel ultrasound technologies for contrast-specific imaging of the macro- and microcirculation have led to a number of new applications for assessment of stroke patients. In particular, ultrasound perfusion imaging has added new perspectives for diagnosis and monitoring of both ischemic and hemorrhagic stroke. Recently, real-time brain perfusion imaging of middle cerebral artery infarctions has been introduced and new quantitative algorithms for evaluation of regional cerebral blood flow are being applied for the first time in humans. Microbubbles enable visualization of carotid artery plaque neovascularization to detect plaque vulnerability. There is growing interest in therapeutic applications of ultrasound, particularly in the field of sonothrombolysis. The treatment of acute ischemic stroke can be improved by ultrasound and microbubbles in combination with thrombolytic drugs. Excitingly, ultrasound and microbubbles may be effective in clot lysis of ischemic stroke even without additional thrombolytic drugs. New therapeutic avenues include opening of the blood-brain barrier (BBB) with ultrasound and microbubbles to enable novel drug delivery to the brain. Microbubbles are also assuming a central role in ultrasound molecular imaging with many targets of interest for evaluating pathophysiologic processes involved in cerebrovascular disease including angiogenesis, inflammation, and thrombus formation.
微泡药理学的快速发展，以及用于宏观和微循环对比特异性成像的新型超声技术，为脑卒中患者的评估带来了许多新的应用。特别是，超声灌注成像为缺血性和出血性脑卒中的诊断和监测增添了新的视角。最近，已经引入了大脑中动脉梗死的实时脑灌注成像，并且首次在人体中应用了新的评估局部脑血流的定量算法。微泡可用于可视化颈动脉斑块新生血管，以检测斑块的脆弱性。超声治疗的应用越来越受到关注，特别是在超声溶栓领域。超声和微泡联合溶栓药物可改善急性缺血性脑卒中的治疗效果。令人兴奋的是，超声和微泡甚至在没有额外溶栓药物的情况下也可能有效地溶解缺血性脑卒中的血栓。新的治疗途径包括利用超声和微泡打开血脑屏障（BBB），以实现新型药物向大脑的输送。微泡在超声分子成像中也起着核心作用，许多感兴趣的靶点可用于评估与脑血管疾病相关的病理生理过程，包括血管生成、炎症和血栓形成。
