高分辨率血管壁成像在颅内动脉粥样硬化疾病中的应用进展
Application of High Resolution Vascular Wall Imaging in Intracranial Atherosclerotic Diseases
DOI: 10.12677/ACM.2024.142632, PDF,   
作者: 于 歆, 班允清*：新疆医科大学第五附属医院影像中心，新疆 乌鲁木齐
关键词: 颅内动脉粥样硬化；血管壁成像；Intracranial Atherosclerosis； Vascular Wall Imaging
摘要: 缺血性脑卒中在我国脑卒中中占主要比例，主要是由于颅内动脉病变引起的动脉狭窄，其主要病因是动脉粥样硬化疾病，目前的指南仅仅依靠管腔的狭窄率来对脑卒中风险进行分层，判断严重程度，决定治疗方案存在一定的局限性的。高分辨率血管壁成像是一种无创且先进的检查技术，可以直接可视化颅内血管壁及其病理变化，利用其优势有助于脑卒中风险的分层，并通过斑块的特征及血管壁的异常来进行鉴别诊断，在各种颅内动脉疾病中近年来有广泛的研究及应用，本文就该项技术在颅内动脉粥样硬化中的影像特征、分型、危险因素等方面进行综述。
Abstract: Ischemic stroke accounts for the major proportion of stroke in China, mainly due to intracranial ar-tery disease caused by artery stenosis, the main cause of which is atherosclerosis. The current guidelines only rely on the stenosis rate of the lumen to stratify stroke risk, judge the severity, and determine the treatment plan, which has certain limitations. As a non-invasive and advanced ex-amination technology, high-resolution vascular wall imaging can directly visualize intracranial vas-cular wall and its pathological changes, and its advantages can contribute to the stratification of stroke risk and differential diagnosis based on plaque characteristics and vascular wall abnormali-ties. In recent years, it has been widely studied and applied in various intracranial artery diseases. This article reviews the imaging features, types, risk factors and treatment of intracranial athero-sclerosis with this technique.
文章引用：于歆, 班允清. 高分辨率血管壁成像在颅内动脉粥样硬化疾病中的应用进展[J]. 临床医学进展, 2024, 14(2): 4554-4559. https://doi.org/10.12677/ACM.2024.142632

参考文献

[1] 王拥军, 李子孝, 谷鸿秋, 等. 中国卒中报告2020(中文版) (1) [J]. 中国卒中杂志, 2022, 17(5): 433-447.
[2] 张国滨, 黄华玮, 郭伟. 中国及非洲青年脑卒中的现状及防治[J]. 中华预防医学杂志, 2022, 56(8): 1142-1149.
[3] Herpich, F. and Rincon, F. (2020) Management of Acute Ischemic Stroke. Critical Care Medicine, 48, 1654-1663. [Google Scholar] [CrossRef] 
[4] Shi, Z., Li, J., Zhao, M., et al. (2021) Progression of Plaque Burden of Intracranial Atherosclerotic Plaque Predicts Recurrent Stroke/Transient Ischemic Attack: A Pilot Follow-Up Study Using Higher-Resolution MRI. Journal of Magnetic Resonance Imaging, 54, 560-570. [Google Scholar] [CrossRef] [PubMed]
[5] Vranic, J.E., Hartman, J.B. and Mossa-Basha, M. (2021) High-Resolution Magnetic Resonance Vessel Wall Imaging for the Evaluation of Intracranial Vascular Pathology. Neuroimaging Clinics of North America, 31, 223-233. [Google Scholar] [CrossRef] [PubMed]
[6] Ojha, R., Huang, D., An, H., et al. (2015) Distribution of Ischemic Infarction and Stenosis of Intra- and Extracranial Arteries in Young Chinese Patients with Ischemic Stroke. BMC Cardi-ovascular Disorders, 15, Article No. 158. [Google Scholar] [CrossRef] [PubMed]
[7] Kang, H.G., Lee, C.H., Shin, B.S., et al. (2021) Characteristics of Symptomatic Basilar Artery Stenosis Using High- Resolution Magnetic Resonance Imaging in Ischemic Stroke Patients. Journal of Atherosclerosis and Thrombosis, 28, 1063-1070. [Google Scholar] [CrossRef] [PubMed]
[8] Pacheco, F.T., Cruz Junior, L., Padilha, I.G., et al. (2020) Current Uses of Intracranial Vessel Wall Imaging for Clinical Practice: A High-Resolution MR Technique Recently Available. Arquivos de Neuro-Psiquiatria, 78, 642-650. [Google Scholar] [CrossRef] [PubMed]
[9] Song, J.W. and Wasserman, B.A. (2020) Vessel Wall MR Im-aging of Intracranial Atherosclerosis. Cardiovascular Diagnosis and Therapy, 10, 982-993. [Google Scholar] [CrossRef] [PubMed]
[10] Mossa-Basha, M., Alexander, M., Gaddikeri, S., et al. (2016) Vessel Wall Imaging for Intracranial Vascular Disease Evaluation. Journal of NeuroInterventional Surgery, 8, 1154-1159. [Google Scholar] [CrossRef] [PubMed]
[11] 赵凡, 杨春华, 王波, 等. 高分辨磁共振血管壁成像对缺血性卒中CISS病因分型的临床意义[J]. 宁夏医学杂志, 2021, 43(7): 621-623.
[12] Chimowitz, M.I., Lynn, M.J., Howlett-Smith, H., et al. (2005) Comparison of Warfarin and Aspirin for Symptomatic Intracranial Arterial Stenosis. The New England Journal of Medicine, 352, 1305-1316. [Google Scholar] [CrossRef] 
[13] Chung, G.H., Kwak, H.S., Hwang, S.B., et al. (2012) High Resolu-tion MR Imaging in Patients with Symptomatic Middle Cerebral Artery Stenosis. European Journal of Radiology, 81, 4069-4074. [Google Scholar] [CrossRef] [PubMed]
[14] Xu, W.H., Li, M.L., Gao, S., et al. (2010) In Vivo High-Resolution MR Imaging of Symptomatic and Asymptomatic Middle Cerebral Artery Atherosclerotic Stenosis. Atherosclerosis, 212, 507-511. [Google Scholar] [CrossRef] [PubMed]
[15] Shi, M.C., Wang, S.C., Zhou, H.W., et al. (2012) Com-pensatory Remodeling in Symptomatic Middle Cerebral Artery Atherosclerotic Stenosis: A High-Resolution MRI and Microemboli Monitoring Study. Neurological Research, 34, 153-158. [Google Scholar] [CrossRef] 
[16] Varnava, A.M., Mills, P.G. and Davies, M.J. (2002) Re-lationship between Coronary Artery Remodeling and Plaque Vulnerability. Circulation, 105, 939-943. [Google Scholar] [CrossRef] [PubMed]
[17] Cai, B. and Peng, B. (2017) Intracranial Artery Stenosis: Current Sta-tus of Evaluation and Treatment in China. Chronic Diseases and Translational Medicine, 3, 197-206. [Google Scholar] [CrossRef] [PubMed]
[18] 林威龙, 贾琳, 王云玲, 等. 高分辨磁共振血管壁成像对高血压患者豆纹动脉血管特征分析的应用研究[J]. 新疆医科大学学报, 2019, 42(11): 1430-1432, 1436.
[19] 刘明, 张国平, 李德炯, 等. 3.0T MR血管壁高分辨成像在颅内血管疾病诊断中的运用价值[J]. 贵州医药, 2022, 46(5): 804-805.
[20] 马念俄. 颅内动脉责任斑块MR血管壁成像的研究进展[J]. 实用放射学杂志, 2021, 37(10): 1724-1727.
[21] Gupta, A., Baradaran, H., Al-Dasuqi, K., et al. (2016) Gadolinium Enhancement in Intracranial Ather-osclerotic Plaque and Ischemic Stroke: A Systematic Review and Meta-Analysis. Journal of the American Heart Associ-ation, 5, e003816. [Google Scholar] [CrossRef] 
[22] Van Der Kolk, A.G., Zwanenburg, J.J., Brundel, M., et al. (2011) Intracranial Vessel Wall Imaging at 7.0-T MRI. Stroke, 42, 2478-2484. [Google Scholar] [CrossRef] 
[23] Ye, Q., Li, L., et al. (2019) Temporal Course and Implica-tions of Intracranial Atherosclerotic Plaque Enhancement on High-Resolution Vessel Wall MRI. Neuroradiology, 61(6). [Google Scholar] [CrossRef] [PubMed]
[24] Qiao, Y., Zeiler, S.R., Mirbagheri, S., et al. (2014) Intracranial Plaque Enhancement in Patients with Cerebrovascular Events on High-Spatial-Resolution MR Images. Radiology, 271, 534-542. [Google Scholar] [CrossRef] [PubMed]
[25] Kim, J.M., Jung, K.H., Sohn, C.H., et al. (2016) Intracranial Plaque Enhancement from High Resolution Vessel Wall Magnetic Resonance Imaging Predicts Stroke Recurrence. In-ternational Journal of Stroke, 11, 171-179. [Google Scholar] [CrossRef] [PubMed]
[26] Yang, D., Liu, Y., Han, Y., et al. (2020) Signal of Carotid Intra-plaque Hemorrhage on MR T1-Weighted Imaging: Association with Acute Cerebral Infarct. AJNR American Journal of Neuroradiology, 41, 836-843. [Google Scholar] [CrossRef] 
[27] Andreas, S., Regina, S., Nishaf, A., et al. (2018) Prediction of Stroke Risk by Detection of Hemorrhage in Carotid Plaques. JACC: Cardiovascular Imaging, 13, 395-406.
[28] 乔晨, 宋清伟, 王峰. 高分辨MR血管壁成像用于颅内动脉粥样硬化疾病研究进展[J]. 中国医学影像技术, 2022, 38(8): 1266-1269.
[29] Zhai, S.J., Jia, L., Kukun, H.J., et al. (2022) Predictive Power of High-Resolution Vessel Wall Mag-netic Resonance Imaging in Ischemic Stroke. American Journal of Translational Research, 14, 664-671.
[30] Luo, J., Bai, X., Tian, Q., et al. (2023) Patterns and Implications of Artery Remodeling Based on High-Resolution Vessel Wall Imaging in Symptomatic Severe Basilar Artery Stenosis. Quantitative Imaging in Medicine and Surgery, 13, 2098-2108. [Google Scholar] [CrossRef] [PubMed]
[31] Zhu, X.J., Du, B., Lou, X., et al. (2013) Morphologic Characteristics of Atherosclerotic Middle Cerebral Arteries on 3T High-Resolution MRI. AJNR American Journal of Neuroradiology, 34, 1717-1722. [Google Scholar] [CrossRef] 
[32] Wexberg, P., Gyöngyösi, M., Sperker, W., et al. (2000) Pre-Existing Arte-rial Remodeling Is Associated with In-Hospital and Late Adverse Cardiac Events after Coronary Interventions in Patients with Stable Angina Pectoris. Journal of the American College of Cardiology, 36, 1860-1869. [Google Scholar] [CrossRef] 
[33] 杨丽, 王效春. 高分辨率磁共振血管壁成像在缺血性脑卒中的应用进展[J]. 磁共振成像, 2022, 13(5): 136-139.
[34] Pasterkamp, G., Galis, Z.S. and De Kleijn, D.P. (2004) Expansive Arterial Remodeling: Location, Location, Location. Arteriosclerosis, Thrombosis, and Vascular Biology, 24, 650-657. [Google Scholar] [CrossRef] 
[35] Xu, W.H., Li, M.L., Gao, S., et al. (2011) Plaque Dis-tribution of Stenotic Middle Cerebral Artery and Its Clinical Relevance. Stroke, 42, 2957-2959. [Google Scholar] [CrossRef] 
[36] Tian, X., Tian, B., Shi, Z., et al. (2021) Assessment of In-tracranial Atherosclerotic Plaques Using 3D Black-Blood MRI: Comparison with 3D Time-of-Flight MRA and DSA. Journal of Magnetic Resonance Imaging, 53, 469-478. [Google Scholar] [CrossRef] [PubMed]
[37] Mazzacane, F., Mazzoleni, V., Scola, E., et al. (2022) Vessel Wall Mag-netic Resonance Imaging in Cerebrovascular Diseases. Diagnostics (Basel), 12, Article No. 258. [Google Scholar] [CrossRef] [PubMed]

为你推荐