Share：
Share this content in WeChat
X
[Chinese] [PDF] 38 1
• Review •
Research progress of magnetic resonance imaging technology in the assessment of blood-spinal cord barrier disruption
ZHANG Dingyu  LIU Yue  ZHANG Li 

Cite this article as: ZHANG D Y, LIU Y, ZHANG L. Research progress of magnetic resonance imaging technology in the assessment of blood-spinal cord barrier disruption[J]. Chin J Magn Reson Imaging, 2026, 17(4): 161-168, 183. DOI:10.12015/issn.1674-8034.2026.04.023.


[Abstract] Disruption of the blood-spinal cord barrier (BSCB) is a critical pathological event in the onset and progression of central nervous system (CNS) diseases. Advances in magnetic resonance imaging (MRI) technology, coupled with a deeper understanding of the BSCB's microstructure and physiological function, have brought the mechanisms underlying BSCB disruption in various CNS disorders into sharp focus. Elucidating these mechanisms is essential for a comprehensive understanding of disease pathophysiology. However, a systematic and comprehensive multimodal MRI framework for assessing BSCB integrity remains lacking.Therefore, this review aims to systematically summarize the structural and functional basis of the BSCB and the molecular mechanisms of its disruption. A primary focus is placed on elucidating the principles and applications of multimodal MRI techniques for the non-invasive, quantitative detection of relevant pathological biomarkers, while also addressing current methodological limitations. Building upon this foundation, the review explores future research directions. The goal is to provide a theoretical basis for developing novel strategies for early disease diagnosis, pathological subtyping, individualized treatment monitoring, and outcome prediction based on imaging biomarkers.
[Keywords] blood-spinal cord barrier；​ spinal cord diseases；​ magnetic resonance imaging；magnetic resonance angiography；diffusion tensor imaging

ZHANG Dingyu   LIU Yue   ZHANG Li*  

Department of Radiology and Nuclear Medicine, the First Hospital of Hebei Medical University, Shijiazhuang 050031, China

Corresponding author: ZHANG L, E-mail: leo054@163.com

Conflicts of interest   None.

Received  2025-10-21
Accepted  2026-03-05
DOI: 10.12015/issn.1674-8034.2026.04.023
Cite this article as: ZHANG D Y, LIU Y, ZHANG L. Research progress of magnetic resonance imaging technology in the assessment of blood-spinal cord barrier disruption[J]. Chin J Magn Reson Imaging, 2026, 17(4): 161-168, 183. DOI:10.12015/issn.1674-8034.2026.04.023.

[1]
NAKAZAKI M, YOKOYAMA T, LANKFORD K L, et al. Mesenchymal stem cells and their extracellular vesicles: therapeutic mechanisms for blood-spinal cord barrier repair following spinal cord injury[J/OL]. Int J Mol Sci, 2024, 25(24): 13460 [2025-10-20]. https://pubmed.ncbi.nlm.nih.gov/39769223/. DOI: 10.3390/ijms252413460.
[2]
WANG K, SU X J, SONG Q X, et al. The circ_006573/miR-376b-3p axis advances spinal cord functional recovery after injury by modulating vascular regeneration[J]. Mol Neurobiol, 2023, 60(9): 4983-4999. DOI: 10.1007/s12035-023-03357-0.
[3]
CHOPRA N, MENOUNOS S, CHOI J P, et al. Blood-spinal cord barrier: its role in spinal disorders and emerging therapeutic strategies[J]. NeuroSci, 2022, 3(1): 1-27. DOI: 10.3390/neurosci3010001.
[4]
WANG J F. Effect and mechanism of miR-335-5p on the structure and function of blood-spinal cord barrier[D]. Guangzhou: Southern Medical University, 2023.
[5]
MEYER T. Amyotrophe lateralsklerose (ALS)-diagnose, verlauf und neue behandlungsoptionen[J]. Dtsch Med Wochenschr, 2021, 146(24/25): 1613-1618. DOI: 10.1055/a-1562-7882.
[6]
PAN Y J, NICOLAZZO J A. Altered blood-brain barrier and blood-spinal cord barrier dynamics in amyotrophic lateral sclerosis: Impact on medication efficacy and safety[J]. Br J Pharmacol, 2022, 179(11): 2577-2588. DOI: 10.1111/bph.15802.
[7]
CHEN G L, WEI F X, LI J C, et al. Intensity of intraoperative spinal cord hyperechogenicity as a novel potential predictive indicator of neurological recovery for degenerative cervical myelopathy[J]. Korean J Radiol, 2021, 22(7): 1163-1171. DOI: 10.3348/kjr.2020.0755.
[8]
GARCIA E, AGUILAR-CEVALLOS J, SILVA-GARCIA R, et al. Cytokine and growth factor activation in vivo and in vitro after spinal cord injury[J/OL]. Mediators Inflamm, 2016, 2016: 9476020 [2025-10-20]. https://pubmed.ncbi.nlm.nih.gov/27418745/. DOI: 10.1155/2016/9476020.
[9]
FAN B Y, WEI Z J, FENG S Q. Progression in translational research on spinal cord injury based on microenvironment imbalance[J/OL]. Bone Res, 2022, 10(1): 35 [2025-10-20]. https://pubmed.ncbi.nlm.nih.gov/35396505/. DOI: 10.1038/s41413-022-00199-9.
[10]
CHEN H, FENG Z, MIN L X, et al. Vagus nerve stimulation prevents endothelial necroptosis to alleviate blood-spinal cord barrier disruption after spinal cord injury[J]. Mol Neurobiol, 2023, 60(11): 6466-6475. DOI: 10.1007/s12035-023-03477-7.
[11]
LI A Y, MCCARTHY L, HRABARCHUK E, et al. Novel grading scales for static and flexion-extension magnetic resonance imaging in patients with cervical spondylotic myelopathy[J/OL]. World Neurosurg, 2023, 173: e218-e227 [2025-10-20]. https://pubmed.ncbi.nlm.nih.gov/36787858/. DOI: 10.1016/j.wneu.2023.02.034.
[12]
SCHMIDT T P, JÜTTEN K, BERTRAM U, et al. Blood spinal cord barrier disruption recovers in patients with degenerative cervical myelopathy after surgical decompression: a prospective cohort study[J/OL]. Sci Rep, 2023, 13(1): 7389 [2025-10-20]. https://pubmed.ncbi.nlm.nih.gov/37149638/. DOI: 10.1038/s41598-023-34004-2.
[13]
TANG H G, GU Y J, JIANG L, et al. The role of immune cells and associated immunological factors in the immune response to spinal cord injury[J/OL]. Front Immunol, 2022, 13: 1070540 [2025-10-20]. https://pubmed.ncbi.nlm.nih.gov/36685599/. DOI: 10.3389/fimmu.2022.1070540.
[14]
ZUO Y M, YE J J, CAI W X, et al. Controlled delivery of a neurotransmitter-agonist conjugate for functional recovery after severe spinal cord injury[J]. Nat Nanotechnol, 2023, 18(10): 1230-1240. DOI: 10.1038/s41565-023-01416-0.
[15]
KIM H W, YONG H, SHEA G K H. Blood-spinal cord barrier disruption in degenerative cervical myelopathy[J/OL]. Fluids Barriers CNS, 2023, 20(1): 68 [2025-10-20]. https://pubmed.ncbi.nlm.nih.gov/37743487/. DOI: 10.1186/s12987-023-00463-y.
[16]
GAO P, YI J, CHEN W J, et al. Pericyte-derived exosomal miR-210 improves mitochondrial function and inhibits lipid peroxidation in vascular endothelial cells after traumatic spinal cord injury by activating JAK1/STAT3 signaling pathway[J/OL]. J Nanobiotechnology, 2023, 21(1): 452 [2025-10-20]. https://pubmed.ncbi.nlm.nih.gov/38012616/. DOI: 10.1186/s12951-023-02110-y.
[17]
VERMA M, SOOD S, SINGH B, et al. Dynamic contrast-enhanced magnetic resonance perfusion volumetrics can differentiate tuberculosis of the spine and vertebral malignancy[J]. Acta Radiol, 2022, 63(11): 1504-1512. DOI: 10.1177/02841851211043838.
[18]
PATEL C B, COHEN D M, AHOBILA-VAJJULA P, et al. Effect of VEGF treatment on the blood-spinal cord barrier permeability in experimental spinal cord injury: dynamic contrast-enhanced magnetic resonance imaging[J]. J Neurotrauma, 2009, 26(7): 1005-1016. DOI: 10.1089/neu.2008.0860.
[19]
COHEN D M, PATEL C B, AHOBILA-VAJJULA P, et al. Blood-spinal cord barrier permeability in experimental spinal cord injury: dynamic contrast-enhanced MRI[J]. NMR Biomed, 2009, 22(3): 332-341. DOI: 10.1002/nbm.1343.
[20]
HSU C C, SETHI S K, HAACKE E M. The current state of susceptibility-weighted imaging and quantitative susceptibility mapping in head trauma[J]. Neuroimaging Clin N Am, 2023, 33(2): 343-356. DOI: 10.1016/j.nic.2023.01.009.
[21]
WANG M Y, DAI Y M, HAN Y H, et al. Susceptibility weighted imaging in detecting hemorrhage in acute cervical spinal cord injury[J]. Magn Reson Imaging, 2011, 29(3): 365-373. DOI: 10.1016/j.mri.2010.10.016.
[22]
LIANG X H, LIANG L, QI X X. Evaluation value of adverse prognosis after intravenous thrombolysis in patients with acute cerebral infarction using MRI-SWI combined with cerebral CT perfusion imaging[J]. J Med Imaging, 2025, 35(5): 16-19, 27. DOI: 10.20258/j.cnki.1006-9011.2025.05.004.
[23]
ZHAO S, HE Y J, GENG Z J, et al. Correlation between SWI prominent cortical venous sign and CT perfusion in acute cerebral infarction with different collateral circulation[J]. Radiol Pract, 2025, 40(2): 211-217. DOI: 10.13609/j.cnki.1000-0313.2025.02.011.
[24]
ZHANG M Z, OU-YANG H Q, LIU J F, et al. Utility of advanced DWI in the detection of spinal cord microstructural alterations and assessment of neurologic function in cervical spondylotic myelopathy patients[J]. J Magn Reson Imaging, 2022, 55(3): 930-940. DOI: 10.1002/jmri.27894.
[25]
COSTANZO R, BRUNASSO L, PAOLINI F, et al. Spinal tractography as a potential prognostic tool in spinal cord injury: a systematic review[J/OL]. World Neurosurg, 2022, 164: 25-32 [2025-10-20]. https://pubmed.ncbi.nlm.nih.gov/35500874/. DOI: 10.1016/j.wneu.2022.04.103.
[26]
CHAI Y X, NIU Y C. Dynamic contrast enhanced MRI combined with intravoxel incoherent motion for preoperative evaluation on pathological type of rectal cancer[J]. Chin J Med Imaging Technol, 2023, 39(12): 1833-1837. DOI: 10.13929/j.issn.1003-3289.2023.12.021.
[27]
TAO J, YIN Z Z, LI X W, et al. Correlation between IVIM parameters and microvessel architecture: direct comparison of MRI images and pathological slices in an orthotopic murine model of rhabdomyosarcoma[J]. Eur Radiol, 2023, 33(12): 8576-8584. DOI: 10.1007/s00330-023-09835-2.
[28]
HARRITZ T, HANSEN B, ZHANG B G, et al. Exploring IVIM-DKI and DKI for assessing microvascular and microstructural changes after traumatic brain injury[J/OL]. NMR Biomed, 2025, 38(9): e70110 [2025-10-20]. https://pubmed.ncbi.nlm.nih.gov/40751360/. DOI: 10.1002/nbm.70110.
[29]
WANG L, WANG J C, YANG Q Q, et al. Improved deep learning-based IVIM parameter estimation via the use of more "realistic" simulated brain data[J]. Med Phys, 2025, 52(4): 2279-2294. DOI: 10.1002/mp.17583.
[30]
REN Z G, YANG D K, XU K N. Changes in diffusion kurtosis imaging and diffusion tensor imaging parameters and their relationship with cognitive ability in patients with mild traumatic brain injury[J]. J Clin Neurol, 2024, 37(4): 261-267. DOI: 10.3969/j.issn.1004-1648.2024.04.007.
[31]
OESCHGER J M, TABELOW K, MOHAMMADI S. Axisymmetric diffusion kurtosis imaging with Rician bias correction: a simulation study[J]. Magn Reson Med, 2023, 89(2): 787-799. DOI: 10.1002/mrm.29474.
[32]
BARRY R L, CONRAD B N, MAKI S, et al. Multi-shot acquisitions for stimulus-evoked spinal cord BOLD fMRI[J]. Magn Reson Med, 2021, 85(4): 2016-2026. DOI: 10.1002/mrm.28570.
[33]
KINANY N, PIRONDINI E, MICERA S, et al. Spinal cord fMRI: a new window into the central nervous system[J]. Neuroscientist, 2023, 29(6): 715-731. DOI: 10.1177/10738584221101827.
[34]
ADDEH A, WILLIAMS R J, GOLESTANI A, et al. Physiological confounds in BOLD-fMRI and their correction[J/OL]. NMR Biomed, 2025, 38(7): e70076 [2025-10-20]. https://pubmed.ncbi.nlm.nih.gov/40491186/. DOI: 10.1002/nbm.70076.
[35]
JIANG Z S, ZHANG W M, ZHANG J R. LncRNA OIP5-AS1 regulates ferroptosis and mitochondrial dysfunction-mediated apoptosis in spinal cord injury by targeting the miR-128-3p/Nrf2 axis[J/OL]. Heliyon, 2024, 10(18): e37704 [2025-10-20]. https://pubmed.ncbi.nlm.nih.gov/39309798/. DOI: 10.1016/j.heliyon.2024.e37704.
[36]
WANG Y F. Analysis of research progress on magnetic resonance imaging of spinal cord injury[J]. China Med Device Inf, 2023, 29(1): 56-58. DOI: 10.3969/j.issn.1006-6586.2023.01.017.
[37]
GRILLHÖSL A, LEISTER I, HÖGEL F, et al. Evolution of MRI parameters from the subacute to chronic phase after human traumatic cervical spinal cord injury: a prospective, studyobservational. part 2: diffusion tensor imaging characteristics[J/OL]. Clin Neuroradiol, 2025 [2025-10-20]. https://pubmed.ncbi.nlm.nih.gov/41134325/. DOI: 10.1007/s00062-025-01579-4.
[38]
TATAR I, CHOU P C, DESOUKI M M, et al. Evaluating regional blood spinal cord barrier dysfunction following spinal cord injury using longitudinal dynamic contrast-enhanced MRI[J/OL]. BMC Med Imaging, 2009, 9: 10 [2025-10-20]. https://pubmed.ncbi.nlm.nih.gov/19519898/. DOI: 10.1186/1471-2342-9-10.
[39]
JIN L Y, LI J, WANG K F, et al. Blood-spinal cord barrier in spinal cord injury: a review[J]. J Neurotrauma, 2021, 38(9): 1203-1224. DOI: 10.1089/neu.2020.7413.
[40]
JIAO G, HUANG D H. Clinical value and MRI advance of iron rim lesions in multiple sclerosis[J]. Chin J Neuroimmunol Neurol, 2023, 30(4): 272-276. DOI: 10.3969/j.issn.1006-2963.2023.04.008.
[41]
YANG B, LI Y M. Research progress on magnetic resonance imaging of chronic active lesions in multiple sclerosis[J]. Chin J Magn Reson Imaging, 2025, 16(1): 193-197, 215. DOI: 10.12015/issn.1674-8034.2025.01.031.
[42]
AUBÉ B, LÉVESQUE S A, PARÉ A, et al. Neutrophils mediate blood-spinal cord barrier disruption in demyelinating neuroinflammatory diseases[J]. J Immunol, 2014, 193(5): 2438-2454. DOI: 10.4049/jimmunol.1400401.
[43]
CARNERO CONTENTTI E, CORREALE J. Neuromyelitis optica spectrum disorders: from pathophysiology to therapeutic strategies[J/OL]. J Neuroinflammation, 2021, 18(1): 208 [2025-10-20]. https://pubmed.ncbi.nlm.nih.gov/34530847/. DOI: 10.1186/s12974-021-02249-1.
[44]
KATSU M, SEKINE-TANAKA M, TANAKA M, et al. Inhibition of repulsive guidance molecule-a ameliorates compromised blood-spinal cord barrier integrity associated with neuromyelitis optica in rats[J/OL]. J Neuroimmunol, 2024, 388: 578297 [2025-10-20]. https://pubmed.ncbi.nlm.nih.gov/38306928/. DOI: 10.1016/j.jneuroim.2024.578297.
[45]
WATTJES M P, CICCARELLI O, REICH D S, et al. 2021 MAGNIMS-CMSC-NAIMS consensus recommendations on the use of MRI in patients with multiple sclerosis[J]. Lancet Neurol, 2021, 20(8): 653-670. DOI: 10.1016/S1474-4422(21)00095-8.
[46]
FILIPPI M, ROCCA M A, CICCARELLI O, et al. MRI criteria for the diagnosis of multiple sclerosis: MAGNIMS consensus guidelines[J]. Lancet Neurol, 2016, 15(3): 292-303. DOI: 10.1016/S1474-4422(15)00393-2.
[47]
ZOU T, HUANG J, LU J. Applications and advances of magnetic resonance imaging in neuromyelitis optic spectrum disorder[J]. J Med Imaging, 2023, 33(7): 1244-1247. DOI: 10.20258/j.cnki.1006-9011.2023.07.027.
[48]
PRILLARD D, CHARBONNEAU F, CLAVEL P, et al. Comparison of a whole-brain contrast-enhanced 3D TSE T1WI versus orbits contrast-enhanced 2D coronal T1WI at 3T MRI for the detection of optic nerve enhancement in patients with acute loss of visual acuity[J]. AJNR Am J Neuroradiol, 2024, 45(7): 965-970. DOI: 10.3174/ajnr.A8233.
[49]
WANG D. A multimodal magnetic resonance study of the hippocampus in patients with optic neuromyelitis optica spectrum disease[D]. Changchun: Jilin University, 2023. DOI: 10.27162/d.cnki.gjlin.2023.004420.
[50]
SMITH P, OGRODNIK N, SATKUNARAJAH J, et al. Characterization of ultrasound-mediated delivery of trastuzumab to normal and pathologic spinal cord tissue[J]. Sci Rep, 2021, 11(1): 4412. DOI: 10.1038/s41598-021-83874-x.
[51]
SHAH L M, SALZMAN K L. Conventional and advanced imaging of spinal cord tumors[J]. Neuroimaging Clin N Am, 2023, 33(3): 389-406. DOI: 10.1016/j.nic.2023.03.001.
[52]
ABUL-KASIM K, THURNHER M M, MCKEEVER P, et al. Intradural spinal tumors: current classification and MRI features[J]. Neuroradiology, 2008, 50(4): 301-314. DOI: 10.1007/s00234-007-0345-7.
[53]
PANG H P, DANG X F, REN Y, et al. DKI can distinguish high-grade gliomas from IDH1-mutant low-grade gliomas and correlate with their different nuclear-to-cytoplasm ratio: a localized biopsy-based study[J]. Eur Radiol, 2024, 34(11): 7539-7551. DOI: 10.1007/s00330-023-10325-8.
[54]
LI Y Y, HU X H, WANG Y J, et al. Dynamic contrast-enhanced MRI intratumoral and peritumoral radiomics combined with clinical indexes for predicting Ki-67 expression of prostate cancer[J]. Chin J Interv Imaging Ther, 2025, 22(6): 389-393. DOI: 10.13929/j.issn.1672-8475.2025.06.005.
[55]
COHEN J, MATHEW A, DOURVETAKIS K D, et al. Recent research trends in neuroinflammatory and neurodegenerative disorders[J/OL]. Cells, 2024, 13(6): 511 [2025-10-20]. https://pubmed.ncbi.nlm.nih.gov/38534355/. DOI: 10.3390/cells13060511.
[56]
LI H N, ZHANG Q L, DUAN Q Q, et al. Brainstem involvement in amyotrophic lateral sclerosis: a combined structural and diffusion tensor MRI analysis[J/OL]. Front Neurosci, 2021, 15: 675444 [2025-10-20]. https://pubmed.ncbi.nlm.nih.gov/34149349/. DOI: 10.3389/fnins.2021.675444.
[57]
IUZZOLINO V V, SCARAVILLI A, CARIGNANI G, et al. Mapping motor and extra-motor gray and white matter changes in ALS: a comprehensive review of MRI insights[J]. Neuroradiology, 2025, 67(7): 1683-1696. DOI: 10.1007/s00234-025-03629-7.

PREV Research progress of blood oxygenation level dependent functional magnetic resonance imaging of spinal cord in spinal cord diseases
NEXT Advances in metabolic imaging technology for nasopharyngeal carcinoma: From mechanisms to applications
  


LINK


Tel & Fax: +8610-67113815    E-mail: editor@cjmri.cn