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Магнитно-резонансная томография в оценке цереброваскулярной реактивности

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Цель исследования: анализ литературы, касающейся методики проведения МРТ-картирования цереброваскулярной реактивности.Материал и методы. Проанализировано 75 публикаций (4 отечественные, 71 зарубежная), вышедших в свет в период с 1960 по 2021 г. Более половины работ было опубликовано в последнее десятилетие, 26 работ — в период с 2016 по 2021 г.Результаты. В статье систематизированы способы оценки цереброваскулярной реактивности и подходы к оценке цереброваскулярной реактивности методом МРТ. Подробно изложена методика проведения бесконтрастного МРТ-картирования цереброваскулярной реактивности с гиперкапнической пробой; также рассмотрены альтернативные вазоактивные стимулы. Обсуждены вопросы, связанные с обработкой данных и оценкой результатов исследования.Заключение. Нарушения цереброваскулярной реактивности играют важную роль в патогенезе сосудистых заболеваний головного мозга. На протяжении последних десятилетий для оценки цереброваскулярной реактивности широко использовались различные радионуклидные и ультразвуковые методы. В последние годы значительно возрос интерес исследователей к МРТ как методу картирования цереброваскулярной реактивности. Неинвазивность, безопасность, отсутствие лучевой нагрузки и хорошая переносимость являются безусловными преимуществами МРТ-картирования перед другими способами оценки цереброваскулярной реактивности. Однако разнообразие методологических подходов к МРТ-картированию цереброваскулярной реактивности обусловливает значительную вариабельность результатов исследования. Стандартизация процедуры должна являться первым шагом на пути внедрения МРТ-картирования цереброваскулярной реактивности в клиническую практику.

Ключевые слова:
цереброваскулярная реактивность, цереброваскулярный резерв, МРТ, cerebrovascular reactivity, cerebrovascular reserve, MRI

Литература:
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Magnetic resonance imaging for cerebrovascular reactivity assessment

Purpose. To analyze the publications related to the technique of MRI mapping of cerebrovascular reactivity.Materials and methods. We have analyzed 75 publications (4 Russian, 71 foreign), published in the period from 1960 to 2021 years. More than half of these articles were published in the last ten years, with 26 studies – in the period from 2016 to 2021 years.Results. The article systematizes methods for assessing cerebrovascular reactivity and approaches to assessing cerebrovascular reactivity by MRI. The technique of non-enhanced MRI mapping of cerebrovascular reactivity with a hypercapnic challenge is described in detail; alternative vasoactive stimuli are also considered. Issues related to data processing and evaluation of research results were discussed.Conclusion. Impairment of cerebrovascular reactivity plays an important role in the pathogenesis of cerebrovascular diseases. Over the past decades, various radionuclide and ultrasound methods have been widely used to assess cerebrovascular reactivity. In recent years the interest of researchers in MRI as a method of mapping cerebrovascular reactivity has increased significantly. Noninvasiveness, safety, absence of radiation exposure, and good tolerability are the absolute advantages of MRI mapping over other methods of assessing cerebrovascular reactivity. However, the variety of methodological approaches to MRI mapping of cerebrovascular reactivity causes significant variability in the results of the study. Standardization of the procedure should be the first step toward the introduction of MRI mapping of cerebrovascular reactivity into clinical practice.

Keywords:
цереброваскулярная реактивность, цереброваскулярный резерв, МРТ, cerebrovascular reactivity, cerebrovascular reserve, MRI