虽然大脑转移瘤（BMs）的治疗方法已从创新的手术技术和放射治疗扩展到包括靶向治疗和免疫治疗，但BMs的预后仍然不良。尽管众多化合物在临床前研究中已被证明具有疗效，但有望治疗剂在血脑屏障（BBB）上的有限渗透仍然是一个未解决的问题。最近，低强度磁共振引导下的聚焦超声（MRgFUS）结合微气泡的方法已被证明能够克服大脑和肿瘤微环境中的血管和细胞运输障碍，从而增加药物扩散并取得初步有效的结果。临床前研究已调查了多种治疗剂（包括多柔比星，曲妥珠单抗和伊匹精单抗）在MRgFUS的帮助下进入中枢神经系统的渗透性，取得了有希望的结果。此外，与MRgFUS引起的BBB开放相结合的抗癌药物已被证明可以改善动物的存活率并减缓肿瘤发展。因此，第一项临床试验最近已经启动，希望结果能为MRgFUS引起的BBB开放增强药物输送在BMs中的安全性和疗效提供证据。本综述旨在概述经颅低强度MRgFUS在BBB破坏中的应用，并全面总结治疗BMs的最相关证据。

Although the therapeutic armamentarium for brain metastases (BMs) has been expanded from innovative surgical techniques and radiotherapy to include targeted therapies and immunotherapy, the prognosis of BMs remains poor. Despite the proven efficacy of numerous compounds in preclinical studies, the limited penetration of promising therapeutic agents across the blood-brain barrier (BBB) remains an unaddressed issue. Recently, low-intensity magnetic resonance-guided focused ultrasound (MRgFUS) in combination with microbubbles has been shown to overcome vascular and cellular transport barriers in the brain and tumor microenvironment, resulting in increased drug diffusion and preliminary effective results. Preclinical studies have investigated the increased penetration of many therapeutic agents including doxorubicin, trastuzumab, and ipilimumab into the CNS with promising results. Furthermore, anticancer drugs combined with MRgFUS-induced BBB opening have been demonstrated to improve animal survival and slow tumor progression. Accordingly, the first clinical trial has recently been launched and hopefully the results will provide evidence for the safety and efficacy of drug delivery enhanced by MRgFUS-induced BBB opening in BMs. This review aims to provide an overview of transcranial low-intensity MRgFUS application for BBB disruption and a comprehensive overview of the most relevant evidence in the treatment of BMs.