中国卒中杂志 ›› 2019, Vol. 14 ›› Issue (08): 797-802.DOI: 10.3969/j.issn.1673-5765.2019.08.012

• 专题综述 • 上一篇    下一篇

脑血管反应性的影像学评估及其在颅内外动脉狭窄性疾病中的应用

徐玉珠,薛红莲,刘俊艳   

  1. 050051 石家庄河北医科大学第三医院神经内科
  • 收稿日期:2019-01-09 出版日期:2019-08-20 发布日期:2019-08-20
  • 通讯作者: 刘俊艳 junyanliu2003@163.com

Application of Neuroimaging Evaluations of Cerebrovascular Reactivity in Intra-extracranial Arterial Stenosis

  • Received:2019-01-09 Online:2019-08-20 Published:2019-08-20

摘要:

良好的脑血管反应性(cerebrovascular reactivity,CVR)是颅内外动脉狭窄或闭塞性病变患 者脑血流动力学失代偿期的重要代偿途径,CVR检测可以预测缺血性卒中的风险和预后,评价血管 重建术的效果。CVR的检测依赖于CO2激发试验或者倾斜实验诱导脑小血管扩张,并通过神经影像 技术检测试验前后脑血流动力学的变化,从而评估CVR。目前常用的CVR检测技术包括直接检测技 术,如CTP、PWI、单光子发射计算机断层扫描、正电子发射断层扫描、氙CT、血氧水平依赖性功能性 磁共振成像、动脉自旋标记技术和间接检测技术TCD。

文章导读: CVR反映脑血流自动调节的能力,应用影像学技术对其进行评估可以辅助临床判断颅内外动脉狭窄或闭塞性疾病患者的卒中风险、治疗选择及预后评估。

关键词: 脑血管反应性; 神经影像; 颅内外动脉狭窄性疾病

Abstract:

Good cerebrovascular reactivity (CVR) is an important compensatory pathway during cerebral hemodynamic decompensation in patients with intra-extracranial arterial severe stenosis or occlusion. CVR assessment can be used to predict the risk and prognosis of ischemic stroke, and evaluate the efficacy of vascular reconstruction. The detection method of CVR as follows: firstly cerebral small vessels are induced to dilatating by CO2 stimulation test or tilt table test, then the cerebral hemodynamic changes before and after vasodilatation are detected by neuroimaging examination. At present, CVR detection techniques include direct detection techniques, such as CTP, PWI, single photon emission computed tomography, Xenon CT, positron emission tomography, blood oxygen level dependent-functional MRI, and arterial spin labeling, and indirect detection techniques such as TCD.

Key words: Cerebrovascular reactivity; Neuroimaging; Intra-extracranial arterial stenosis