The blood-brain barrier (BBB) is a major anatomical and physiological barrier limiting the passage of drugs into brain. Central nervous system tumors can impair the BBB by changing the tumor microenvironment leading to the formation of a leaky barrier, known as the blood-tumor barrier (BTB). Despite the change in integrity, the BTB remains effective in preventing delivery of chemotherapy into brain tumors. Focused ultrasound is a unique noninvasive technique that can transiently disrupt the BBB and increase accumulation of drugs within targeted areas of the brain. Herein, we summarize the current understanding of different types of targeted ultrasound mediated BBB/BTB disruption techniques. We also discuss influence of the tumor microenvironment on BBB opening, as well as the role of immunological response following disruption. Lastly, we highlight the gaps between evaluation of the parameters governing opening of the BBB/BTB. A deeper understanding of physical opening of the BBB/BTB and the biological effects following disruption can potentially enhance treatment strategies for patients with brain tumors.

血脑屏障 (BBB) 是限制药物进入大脑的主要解剖和生理屏障。中枢神经系统肿瘤可以通过改变肿瘤微环境来损害血脑屏障，导致形成渗漏屏障，称为血肿瘤屏障 (BTB)。尽管完整性发生了变化，但 BTB 在防止将化疗药物输送到脑肿瘤方面仍然有效。聚焦超声是一种独特的非侵入性技术，可以暂时破坏 BBB 并增加药物在大脑目标区域内的积累。在此，我们总结了目前对不同类型的靶向超声介导的 BBB/BTB 破坏技术的理解。我们还讨论了肿瘤微环境对 BBB 开放的影响，以及中断后免疫反应的作用。最后，我们强调了 BBB/BTB 开放参数评估之间的差距。更深入地了解 BBB/BTB 的物理开放和破坏后的生物学效应可能会增强脑肿瘤患者的治疗策略。