功能磁共振成像和正电子发射断层摄影技术在麻醉学研究中应用.docVIP

功能磁共振成像和正电子发射断层摄影技术功能磁共振成像和正电子发射断层摄影技术正电子发射断层摄影技术受体GABAA受体参与介导全麻药在人体内发挥作用的机制，后者产生的神经抑制过程又并非仅有GABAA受体的参与，而是一个更加复杂的过程。在疼痛研究中的结果表明，阿片类镇痛药能使痛觉感受相关区域（扣带前回、岛叶和丘脑）的活性降低，同时使参与痛觉调节的相关区域（扣带回-额前皮质、中脑导水管周围灰质功能磁共振成像正电子发射断层摄影技术局部脑血流量plication of fMRI and PET in the Study of Anesthesia LIU Zhen-zhen，YU Bu-wei，ZHANG Fu-jun，XUE Qing-sheng，ZHAO Xin，LUO Yan [Abstract] With the development of functional imaging, especially the wide use of functional magnetic resonance imaging and positron emission tomography, the studies of anesthesia have progressed a lot in the mechanism of general anesthesia and pain. The results provided by the studies of general anesthesia mechanisms show that the general anaesthetics can drease the neuronal activities in some cerebral areas and increase in some other regions. Generally speaking, the regional cerebral blood flows in the anterior cingulate cortex and insula are raising, while in the thalamus is decreasing. The special application of positron emission tomography in the cerebral receptor system confirmed that effects of anaesthetics in vivo are mediated partly through GABAergic mechanisms. And the results got from pain studying show that opioid analgesia decreases the neuronal activity in the regions linked to pain perception(cingulate cortex, insula and thalamus) and increases neuronal activity in the regions linked to pain modulation (cingulo-frontal cortex and the peri-aqueductal gray matter). [Key words] fMRI；PET；rCBF；receptor；pain 近年来，随着功能影像学技术的不断改进和发展，越来越多的研究人员将其应用到各个领域，麻醉学也不例外。功能影像学的介入，不但使我们对的认识在研究中的功能磁共振成像（functional magnetic resonance imaging, fMRI）和正电子发射断层摄影技术(positron emission tomography, PET)局部脑血流量regional cerebral blood flow, rCBF)或局部脑葡萄糖代谢率(regional cerebral metabolic rate of glucose, rCMRGlu)等的检测来评价大脑的功能活动状态。本文就近年来这两种技术在麻醉学研究中的主要应用作一综述。 1. fMRI和PET的工作原理 1.1 fMRI fMRI是从20世纪90年代初，在传统MRI的基础上。fMRI的出现标志着临床磁共振诊断从单一形态学研究，到形态与功能相结合的系统研究。fMRI的方法很多，注射造影剂、灌注加权及血氧水平依赖（blood oxygenation level dependent，BOLD）目前应用最广泛的BOLD效应成像法。原理是当局部脑区的神经元功能活动对局部氧耗