定量多回波T2脑脊液分数图谱揭示健康成人睡眠-觉醒依赖性脑流体转移
结果显示日间多个脑区CSFF增加而夜间睡眠时降低，提示CSFF图谱可无创、全脑、体素化评估睡眠-觉醒相关的脑流体再分布，可能作为探测类淋巴功能的MRI生物标志物。
要点
- 多回波T2衍生的CSFF图谱可体素化量化脑内长T2（类CSF）水组分。
- 日间觉醒期多个脑区CSFF升高，夜间睡眠期CSFF降低。
- CSFF变化见于双侧壳核、右侧尾状核、双侧顶叶/枕叶皮质及双侧脑白质。
关键影像表现/征象
- 日间觉醒期多个脑区CSFF增加，而夜间睡眠期CSFF降低。
- 相对CSFF变化在双侧壳核、右侧尾状核、双侧顶叶皮质、双侧枕叶皮质及双侧脑白质中日间与夜间周期之间差异有统计学意义（均P < .05）。
- 左侧壳核相对CSFF变化中位数日间为1.12%（IQR：-3.55至10.08），夜间为-3.41%（IQR：-21.45至2.81）。
- 左侧顶叶皮质相对CSFF变化中位数日间为10.58%（IQR：6.59至14.01），夜间为-5.91%（IQR：-8.55至-2.35）。
- 体素化图谱和直方图位移与上述区域效应一致。
临床应用与阅片要点
- 可利用多回波T2成像后处理生成CSFF图谱，在基底节、顶叶、枕叶皮质及脑白质等ROI中评估类CSF水组分。
- 阅片时注意日间觉醒与夜间睡眠状态可能导致CSFF测量差异，报告解读需结合扫描时间与睡眠状态。
- CSFF变化幅度以相对变化（12 h - 0 h）表示，报告时应注明参考时间点与睡眠/觉醒条件。
局限性
- 研究为单中心前瞻性自身交叉设计，外推性有限。
- 随访扫描在静脉注射GBCA后12 h进行，CSFF测量可能受对比剂影响。
以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。
英文原文（摘要）· 点击展开
BACKGROUND AND PURPOSE: Sleep enhances CSF movement along the perivascular spaces, promoting more efficient clearance of waste from the brain. We determined whether quantitative multi-echo T2-derived cerebrospinal fluid fraction (CSFF) mapping detects sleep-wake-dependent changes in brain free-water compartments in healthy adults.
MATERIALS AND METHODS: In this prospective within-subject crossover study, sixteen healthy adults (20-30 years) completed two scan cycles (day cycle with wakeful daytime activity and night cycle with natural nocturnal sleep) separated by a 1-week washout. Each cycle included baseline (precontrast [0 h]) and follow-up (12h after intravenous injection of the GBCA) multi-echo T2 imaging. CSFF maps were computed voxel-wise using multiexponential T2 decomposition to quantify the long T2 (CSF-like) component relative to the total water signal. ROI-based analyses and histogram evaluations were performed in the basal ganglia, frontal, parietal, and occipital cortices, insula, and cerebral WM. Paired comparisons of the relative CSFF changes (12 h - 0 h) between the day and night cycles were performed using the Wilcoxon signed-rank test.
RESULTS: Relative CSFF change differed between day and night cycles in the bilateral putamina, right caudate nucleus, bilateral parietal cortices, bilateral occipital cortices, and bilateral cerebral WMs (all P < .05). During daytime wakefulness, CSFF increased across regions, whereas nighttime sleep was associated with reduced CSFF (left putamen: median, 1.12% [IQR: -3.55 to 10.08] (day) vs. median, -3.41% [IQR: -21.45 to 2.81] (night); left parietal cortex: median, 10.58% [IQR: 6.59 to 14.01] (day) vs. median, -5.91% [IQR: -8.55 to -2.35] (night)). Voxel-wise maps and histogram shifts were consistent with these regional effects.
CONCLUSIONS: Quantitative multi-echo T2-based CSFF mapping provides noncontrast, whole-brain, voxel-wise assessment of sleep-wake-related brain fluid redistribution and may serve as an MRI biomarker to probe glymphatic function in humans.
引用
- Lee G, Woo MK, Choi SH, et al. Quantitative multi-echo T2-based cerebrospinal fluid fraction (CSFF) mapping reveals sleep-wake-dependent brain fluid shifts in healthy adults. AJNR Am J Neuroradiol. 2026. PMID: 42134992. doi:10.3174/ajnr.A9412
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。