阿尔茨海默病淀粉样蛋白相关影像学异常的影像识别与评估
淀粉样蛋白相关影像学异常(amyloid-related imaging abnormalities,ARIA)为磁共振成像(magnetic resonance imaging,MRI)观察到的颅内信号异常,是阿尔茨海默病(Alzheimer's disease,AD)抗β淀粉样蛋白(amyloid-β,Aβ)单克隆抗体治疗的主要不良事件之一,严重者可危及患者生命.随着首个抗Aβ单克隆抗体在中国获批使用,临床科室在真实世界中面对ARIA的可能性将增加.ARIA在用药前的风险评估、用药期间的及时识别与严重程度判断对临床决策具有重要意义.对ARIA的识别评估可以从影像和临床症状两方面进...
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| Published in | 四川大学学报（医学版） Vol. 55; no. 6; pp. 1364 - 1370 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | Chinese |
| Published |
四川大学华西医院放射科(成都 610041)%昆明医科大学第一附属医院神经内科(昆明 650032)%四川大学华西医院神经内科(成都 610041)
20.11.2024
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1672-173X |
| DOI | 10.12182/20241160201 |
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| Abstract | 淀粉样蛋白相关影像学异常(amyloid-related imaging abnormalities,ARIA)为磁共振成像(magnetic resonance imaging,MRI)观察到的颅内信号异常,是阿尔茨海默病(Alzheimer's disease,AD)抗β淀粉样蛋白(amyloid-β,Aβ)单克隆抗体治疗的主要不良事件之一,严重者可危及患者生命.随着首个抗Aβ单克隆抗体在中国获批使用,临床科室在真实世界中面对ARIA的可能性将增加.ARIA在用药前的风险评估、用药期间的及时识别与严重程度判断对临床决策具有重要意义.对ARIA的识别评估可以从影像和临床症状两方面进行,本文聚焦于前者,对ARIA的病理生理学机制、流行病学及临床特点、影像检查方案及影像评估进行综述.本文最后指出,目前ARIA相关研究数据多来自高加索人种的药物临床试验,缺乏中国人真实世界应用抗Aβ单克隆抗体的治疗经验,未来的用药前风险评估仍有许多尚待探讨的问题.此外,是否存在其他帮助预判药物风险的临床因素和影像指标,使用不同的成像条件是否给真实世界的患者管理带来差异,都需要进一步探索. |
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| AbstractList | 淀粉样蛋白相关影像学异常(amyloid-related imaging abnormalities,ARIA)为磁共振成像(magnetic resonance imaging,MRI)观察到的颅内信号异常,是阿尔茨海默病(Alzheimer's disease,AD)抗β淀粉样蛋白(amyloid-β,Aβ)单克隆抗体治疗的主要不良事件之一,严重者可危及患者生命.随着首个抗Aβ单克隆抗体在中国获批使用,临床科室在真实世界中面对ARIA的可能性将增加.ARIA在用药前的风险评估、用药期间的及时识别与严重程度判断对临床决策具有重要意义.对ARIA的识别评估可以从影像和临床症状两方面进行,本文聚焦于前者,对ARIA的病理生理学机制、流行病学及临床特点、影像检查方案及影像评估进行综述.本文最后指出,目前ARIA相关研究数据多来自高加索人种的药物临床试验,缺乏中国人真实世界应用抗Aβ单克隆抗体的治疗经验,未来的用药前风险评估仍有许多尚待探讨的问题.此外,是否存在其他帮助预判药物风险的临床因素和影像指标,使用不同的成像条件是否给真实世界的患者管理带来差异,都需要进一步探索. |
| Abstract_FL | Amyloid-related imaging abnormalities(ARIA),intracranial signal abnormalities observed in magnetic resonance imaging(MRI),represent one of the main adverse events associated with treating Alzheimer's disease(AD)with anti-amyloid-β(anti-Aβ)monoclonal antibodies.In severe cases,patients'lives may be threatened.As the first anti-Aβ antibody was approved for use in China,clinical departments are now confronted with an increased likelihood of encountering ARIA in real-world scenarios.Accurate pre-treatment risk assessment,timely identification during medication,and severity evaluation of ARIA are of great significance in guiding clinical decisions.The identification and assessment of ARIA can be conducted from two perspectives—imaging and clinical symptoms.This article focuses on imaging.We reviewed the pathophysiological mechanisms,epidemiological and clinical characteristics,and imaging protocols and assessment of ARIA.We also stated at the end of the review that most current research data on ARIA came from clinical drug trials involving Caucasian populations,and that there was a lack of treatment experience in the real-world application of anti-Aβ monoclonal antibodies in Chinese populations.Many issues concerning pre-treatment risk assessment still need to be explored.Additionally,whether there are other clinical factors and imaging indicators that can help predict drug risks,and whether using different imaging protocols can help make a difference in patient management in the real world all require further investigation. |
| Author | 吕粟 李婉婷 陈芹 杨兴隆 胡娜 杨曦玥 李红霞 |
| AuthorAffiliation | 四川大学华西医院放射科(成都 610041)%昆明医科大学第一附属医院神经内科(昆明 650032)%四川大学华西医院神经内科(成都 610041) |
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| Author_FL | LI Wanting LYU Su YANG Xinglong YANG Xiyue HU Na CHEN Qin LI Hongxia |
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| DocumentTitle_FL | Radiological Identification and Evaluation of Amyloid-Related Imaging Abnormalities in Alzheimer's Disease |
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| Keywords | Anti-amyloid-β immunotherapies 抗Aβ免疫治疗 磁共振成像 Magnetic resonance imaging Amyloid-related imaging abnormalities Anti-amyloid-β monoclonal antibodies 淀粉样蛋白相关影像学异常 阿尔茨海默病 抗Aβ单克隆抗体 综述 Review Alzheimer's disease |
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| Title | 阿尔茨海默病淀粉样蛋白相关影像学异常的影像识别与评估 |
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