中国脑小血管病的神经影像学诊断标准及名词标准化定义——来自中国卒中学会的专家共识

doi:10.3969/j.issn.1673-5765.2024.04.002

中国卒中杂志 ›› 2024, Vol. 19 ›› Issue (4): 376-404.DOI: 10.3969/j.issn.1673-5765.2024.04.002

中国脑小血管病的神经影像学诊断标准及名词标准化定义——来自中国卒中学会的专家共识

陈玮琪^1*，徐佳洁^2，3*，陆瑶¹，王玲¹，曹瑾怡^2，3，陈鸿宾¹，郭蕾¹，吕琰琛^2，3，汤晗^2，3，王赞¹，徐非凡^2，3，颜庭梦^2，3，应云清^2，3，仲伟逸^2，3，周蓉^2，3，陆正齐⁴，程忻^2，3，王伊龙^{1，3，5，6，7，8，9，10}，中国卒中学会脑小血管病分会（*第一作者）

1 北京 100070首都医科大学附属北京天坛医院神经病学中心
2 复旦大学附属华山医院神经内科
3 国家神经疾病医学中心
4 中山大学附属第三医院神经内科
5 北京脑科学与类脑研究中心
6 临床流行病学北京市重点实验室
7 首都医科大学人脑保护高精尖创新中心
8 国家神经系统疾病临床医学研究中心
9 口腔健康北京实验室
10 首医-天坛联合实验室

收稿日期:2024-02-07 出版日期:2024-04-20 发布日期:2024-04-20
通讯作者: 王伊龙 yilong528@aliyun.com 程忻 chengxin@fudan.edu.cn 陆正齐 lzq1828@aliyun.com

Neuroimaging Diagnostic Criteria and Standardized Definition of Terms for Small Vessel Disease in China—Expert Consensus from the Chinese Stroke Association

CHEN Weiqi^1*, XU Jiajie^2,3*, LU Yao¹, WANG Ling¹, CAO Jinyi^2,3, CHEN Hongbin¹, GUO Lei¹, LYU Yanchen^2,3, TANG Han^2,3, WANG Zan¹, XU Feifan^2,3, YAN Tingmeng^2,3, YING Yunqing^2,3, ZHONG Weiyi^2,3, ZHOU Rong^2,3, LU Zhengqi⁴, CHENG Xin^2,3, WANG Yilong^{1,3,5,6,7,8,9,10}, Small Vessel Disease Branch of Chinese Stroke Association (*contributed equally)

1 Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China;
2 Department of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China;
3 National Center for Neurological Disorders, Beijing 100070, China;
4 Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China;
5 Chinese Institute for Brain Research, Beijing 102206, China;
6 Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China;
7 Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100070, China;
8 China National Clinical Research Center for Neurological Diseases, Beijing 100070, China;
9 Beijing Laboratory of Oral Health, Capital Medical University, Beijing 100069, China;
10 Laboratory for Clinical Medicine, Capital Medical University, Beijing 100070, China

Received:2024-02-07 Online:2024-04-20 Published:2024-04-20
Contact: WANG Yilong, E-mail: yilong528@aliyun.com CHENG Xin, E-mail: chengxin@fudan.edu.cn LU Zhengqi, E-mail: lzq1828@aliyun.com

摘要/Abstract

摘要： 脑小血管病（small vessel disease，SVD）是一类以脑内小血管受损为主的临床影像综合征，可能会导致卒中、血管性认知障碍、神经心理疾病与其他功能障碍等。自2013年血管性神经病变的影像报告标准（standards for reporting vascular changes on neuroimaging，STRIVE）发布以来，SVD的神经影像学特征得到了初步的分类与标准化。然而，在临床实践与科学研究中，对SVD影像特征的认识和应用仍存在诸多不一致和不规范之处。随着对SVD病理生理机制的深入探索与影像技术的不断进步，新的SVD影像特征和定量标志物被相继发现，为SVD的诊断和评估提供了更为全面且精准的信息。在此基础上，STRIVE-2应运而生，以期能更全面地揭示SVD对脑功能与结构的影响。为了规范中国SVD的神经影像学评估和诊断，本共识将在STRIVE-2的基础上，结合中国具体国情，对SVD的神经影像学特征进行深入解读，旨在推动SVD影像学诊断术语的标准化，提高临床诊断的准确性，进一步促进相关领域的研究与进步。

关键词: 脑小血管病; 影像学诊断; 定义; 专家共识

Abstract: Small vessel disease (SVD) is a clinical and imaging syndrome characterized by damage to small blood vessels in the brain, which can lead to stroke, vascular cognitive impairment, neuropsychological diseases, and other functional impairments. Since the publication of the standards for reporting vascular changes on neuroimaging (STRIVE) in 2013, the neuroimaging features of SVD have been preliminarily classified and standardized. However, there are still inconsistencies and lack of standardization in the understanding and application of SVD imaging features in clinical practice and scientific research. With the deepening exploration of the pathophysiological mechanisms of SVD and the continuous advancement of imaging technology, new imaging features and quantitative biomarkers of SVD have been discovered, providing more comprehensive and accurate information for the diagnosis and assessment of SVD. Based on this, the STRIVE-2 has been developed to comprehensively reveal the effects of SVD on brain function and structure. In order to standardize the neuroimaging evaluation and diagnosis of SVD in China, this consensus will provide a detailed interpretation of the neuroimaging features of SVD based on the STRIVE-2, combined with the specific national conditions of China, aiming to promote the standardization of the terms of SVD imaging diagnosis, improve the accuracy of clinical diagnosis, and further promote the research and progress in related fields.

Key words: Small vessel disease; Imaging diagnosis; Definition; Expert consensus

中图分类号:

陈玮琪, 徐佳洁, 陆瑶, 王玲, 曹瑾怡, 陈鸿宾, 郭蕾, 吕琰琛, 汤晗, 王赞, 徐非凡, 颜庭梦, 应云清, 仲伟逸, 周蓉, 陆正齐, 程忻, 王伊龙, 中国卒中学会脑小血管病分会. 中国脑小血管病的神经影像学诊断标准及名词标准化定义——来自中国卒中学会的专家共识[J]. 中国卒中杂志, 2024, 19(4): 376-404.

CHEN Weiqi, XU Jiajie, LU Yao, WANG Ling, CAO Jinyi, CHEN Hongbin, GUO Lei, LYU Yanchen, TANG Han, WANG Zan, XU Feifan, YAN Tingmeng, YING Yunqing, ZHONG Weiyi, ZHOU Rong, LU Zhengqi, CHENG Xin, WANG Yilong, Small Vessel Disease Branch of Chinese Stroke Association. Neuroimaging Diagnostic Criteria and Standardized Definition of Terms for Small Vessel Disease in China—Expert Consensus from the Chinese Stroke Association[J]. Chinese Journal of Stroke, 2024, 19(4): 376-404.

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中国脑小血管病的神经影像学诊断标准及名词标准化定义——来自中国卒中学会的专家共识

Neuroimaging Diagnostic Criteria and Standardized Definition of Terms for Small Vessel Disease in China—Expert Consensus from the Chinese Stroke Association

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