慢性中風病人接種幹細胞後以磁振造影追蹤及測量灌流變化的應用和限制

Abstract

中風為2010年台灣第三大死因，但目前尚無任何讓慢性中風病人神經再生的治療方法。有越來越多的動物研究顯示，幹細胞將是中風未來一個嶄新的治療。在本院臨床二期試驗中，我們將大腦周邊血液的造血幹細胞(CD34+)植入慢性中風患者腦內，並運用MRI非侵入性的特點，以R2*弛緩率觀察被超順磁性氧化鐵顯影劑標幟之植入幹細胞。 由動物研究推測，CD34+細胞能誘導缺血區的血管新生，此發現推測在神經再生中扮演重要角色。因此，我們希望以T2*灌流序列量測慢性中風病人在接種幹細胞前後的腦血流改變，證明腦血流速及腦血流量增加與幹細胞移植的相關性。

Stroke is the 3rd leading cause of death in Taiwan on 2010. In the chronic stage, no treatment currently exists to restore lost neurological function after stroke. A growing number of studies highlight the potential of stem cell transplantation in animal model as a novel therapeutic approach for stroke. One phase II clinical trial in our institution studied the therapeutic effects with intracerebral peripheral blood hematopoietic stem cell (CD34+) implantation for chronic stroke patients. This regular MRI follow-ups are aimed to noninvasively monitor the fate, behavior of the implanted stem cells labeled with superparamganetic iron oxide by R2* relaxivity. Besides, since animal studies hypothesize that CD34+ cells may play a positive role in neuroregeneration by inducing neovascularization in the ischemic zone, we want to test the hypothesis of increased cerebral blood flow and volume associated with stem cell implantation, also by MR T2* perfusion sequence.