Wåhlin Anders, Eklund Anders, Malm Jan
Department of Radiation Sciences, Umeå University, Umeå, Sweden.
Department of Applied Physics and Electronics, Umeå University, Umeå, Sweden.
J Intern Med. 2022 Feb;291(2):115-127. doi: 10.1111/joim.13392. Epub 2021 Nov 23.
Alterations in cerebral blood flow are common in several neurological diseases among the elderly including stroke, cerebral small vessel disease, vascular dementia, and Alzheimer's disease. 4D flow magnetic resonance imaging (MRI) is a relatively new technique to investigate cerebrovascular disease, and makes it possible to obtain time-resolved blood flow measurements of the entire cerebral arterial venous vasculature and can be used to derive a repertoire of hemodynamic biomarkers indicative of cerebrovascular health. The information that can be obtained from one single 4D flow MRI scan allows both the investigation of aberrant flow patterns at a focal location in the vasculature as well as estimations of brain-wide disturbances in blood flow. Such focal and global hemodynamic biomarkers show the potential of being sensitive to impending cerebrovascular disease and disease progression and can also become useful during planning and follow-up of interventions aiming to restore a normal cerebral circulation. Here, we describe 4D flow MRI approaches for analyzing the cerebral vasculature. We then survey key hemodynamic biomarkers that can be reliably assessed using the technique. Finally, we highlight cerebrovascular diseases where one or multiple hemodynamic biomarkers are of central interest.
脑血流量改变在包括中风、脑小血管病、血管性痴呆和阿尔茨海默病在内的几种老年神经疾病中很常见。四维血流磁共振成像（4D流MRI）是一种用于研究脑血管疾病的相对较新的技术，它能够获取整个脑动脉静脉血管系统的时间分辨血流测量数据，并可用于得出一系列指示脑血管健康的血流动力学生物标志物。从单次4D流MRI扫描中获得的信息既可以用于研究血管系统中局部位置的异常血流模式，也可以用于估计全脑血流紊乱情况。这种局部和整体的血流动力学生物标志物显示出对即将发生的脑血管疾病和疾病进展敏感的潜力，并且在旨在恢复正常脑循环的干预措施的规划和随访过程中也可能会发挥作用。在此，我们描述用于分析脑血管系统的4D流MRI方法。然后，我们概述可以使用该技术可靠评估的关键血流动力学生物标志物。最后，我们重点介绍了一种或多种血流动力学生物标志物备受关注的脑血管疾病。
