MR-basierte Methoden der funktionellen Bildgebung des zentralen Nervensystems
MR-Based Methods of the Functional Imaging of the CNSF. L. Giesel1
, T. Wüstenberg2
, A. Bongers3
, M. A. Weber1
, C. Zechmann1
, K. T. Baudendistel3
, H. von Tengg-Kobligk1
, H. K. Hahn4
, M. Essig1
, H.-U Kauczor1
Im vorliegenden Artikel werden die gebräuchlichsten Methoden der funktionellen MR-Bildgebung dargestellt. Der Schwerpunkt liegt dabei auf der Abbildung funktioneller Prozesse und deren Pathologie im Zentralnervensystem. Es werden die physikalisch-physiologischen Grundlagen kontrastmittelverstärkter und kontrastmittelfreier Verfahren dargestellt und es wird ihr Potenzial bezüglich einer klinischen Anwendung anhand ausgewählter Fälle diskutiert. Im Bereich der kontrastmittelverstärkten MR-Techniken wird insbesondere auf die T1- und T2*-dynamische MRT eingegangen. Ausgehend von verschiedenen pharmakokinetischen Modellen der Kontrastmittelanreicherung werden diagnostische Ansätze für die Neurologie und Strahlentherapie diskutiert. Die kontrastmittelfreien Verfahren werden am Beispiel der Blood Oxygenation Level Dependent (BOLD)-fMRT und des Arterial Spin Labelings (ASL) dargestellt und ihre diagnostische Relevanz wird an verschiedenen klinischen Beispielen aus der Psychiatrie und Neurochirurgie erläutert. Abschließend wird ein vergleichender Ausblick bezüglich der zu erwartenden Entwicklungen auf dem Gebiet der funktionellen MRT gegeben.
Abstract
This review presents the basic principles of functional imaging of the central nervous system utilizing magnetic resonance imaging. The focus is set on visualization of different functional aspects of the brain and related pathologies. Additionally, clinical cases are presented to illustrate the applications of functional imaging techniques in the clinical setting. The relevant physics and physiology of contrast-enhanced and non-contrast-enhanced methods are discussed. The two main functional MR techniques requiring contrast-enhancement are dynamic T1- and T2*-MRI to image perfusion. Based on different pharmacokinetic models of contrast enhancement diagnostic applications for neurology and radio-oncology are discussed. The functional non-contrast enhanced imaging techniques are based on “blood oxygenation level dependent (BOLD)-fMRI and arterial spin labeling (ASL) technique. They have gained clinical impact particularly in the fields of psychiatry and neurosurgery.
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