朱孟蝶,孟 莉

定量磁化率成像（Quantitative susceptibility mapping，QSM）是一种描述和量化磁化率源的磁共振技术，可以精确测量脑组织的铁浓度。近年来，QSM被广泛用于研究大脑中各种主要磁化率源，包括铁、含铁血黄素、脱氧血红蛋白（顺磁性）以及钙化(抗磁性)。在此，回顾总结QSM在医疗管理、疾病的诊断和未来发展方向中的应用。在指导医疗管理方面，QSM可用于监测帕金森病（PD）患者的铁配合治疗，监测血脑屏障(BBB)闭合后多发性硬化（MS）病变的郁积炎症以及监测脑出血时的血肿体积。为了帮助疾病的早期诊断，QSM可以识别肌萎缩性侧索硬化症患者的运动皮质、PD患者的黑质、亨廷顿病患者的苍白球、壳核和尾状核以及威尔逊病患者的基底神经节中的铁水平升高。此外，QSM可以区分出血和钙化，这可能有助于肿瘤亚分类，并可以测量外伤性脑损伤患者的微出血。最后，我们讨论了未来的发展方向，包括骨QSM，心脏QSM等。总之，本文综述了QSM在临床中的应用现状及研究进展。

定量磁化率成像；QSM；铁；神经退行性疾病

[1] Barbosa JH,Santos AC,Tumas V,et al.Quantifying brain iron deposition in patients with Parkinson's disease using quantitative susceptibility mapping,R2 and R2.Magn Reson Imaging 2015;33:559-565. [2] Deistung A,Schweser F,Reichenbach JR.Overview of quantitative susceptibility mapping.NMR Biomed 2017;30. [3] Du G,Liu T,Lewis MM,et al.Quantitative susceptibility mapping of the midbrain in Parkinson's disease.Mov Disord 2016;31:317-324. [4] Lassmann H.Pathophysiology of inflammation and tissue injury in multiple sclerosis:what are the targets for therapy.J Neurol Sci 2011;306:167-169. [5] Tan H,Zhang L,Mikati AG,et al.Quantitative Susceptibility Mapping in Cerebral Cavernous Malformations:Clinical Correlations.AJNR Am J Neuroradiol 2016;37:1209-1215. [6] Guan X,Xuan M,Gu Q,et al.Regionally progressive accumulation of iron in Parkinson's disease as measured by quantitative susceptibility mapping.NMR Biomed 2017;30. [7] Domínguez JF,Ng AC,Poudel G,et al.Iron accumulation in the basal ganglia in Huntington's disease:cross-sectional data from the IMAGE-HD study.J Neurol Neurosurg Psychiatry 2016;87:545-549. [8] Fritzsch D,Reiss-Zimmermann M,Trampel R,et al.Seven-tesla magnetic resonance imaging in Wilson disease using quantitative susceptibility mapping for measurement of copper accumulation.Invest Radiol 2014;49:299-306. [9] Schweitzer AD,Liu T,Gupta A,et al.Quantitative susceptibility mapping of the motor cortex in amyotrophic lateral sclerosis and primary lateral sclerosis.AJR Am J Roentgenol 2015;204:1086-1092. [10] Chawla S,Kister I,Wuerfel J,et al.Iron and Non-Iron-Related Characteristics of Multiple Sclerosis and Neuromyelitis Optica Lesions at 7T MRI.AJNR Am J Neuroradiol 2016;37:1223-1230. [11] Deistung A,Schweser F,Wiestler B,et al.Quantitative susceptibility mapping differentiates between blood depositions and calcifications in patients with glioblastoma.PLoS One 2013;8:e57924. [12] Liu W,Soderlund K,Senseney JS,et al.Imaging Cerebral Microhemorrhages in Military Service Members with Chronic Traumatic Brain Injury.Radiology 2016;278:536-545.

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