Abstract: Cerebral small vessel disease (SVD) is a common disease in the aging process that would result in stroke, cognitive impairment, neuropsychological disorders or symptoms, and other functional impairments. Standards for reporting vascular changes on neuroimaging-1 (STRIVE-1) categorised and standardised the diverse features of SVD that are visible on structural MRI, including white matter hyperintensity, perivascular space, cerebral microbleed, recent small subcortical infarcts, lacune (of presumed vascular origin) and brain atrophy. With the understanding of the influence of SVD image features becoming clearer, combined with the rapidly emerging machine learning methods, a new neuroimaging standard for the study of small cerebral vascular disease has been updated which is STRIVE-2. In order to capture the effect of SVD on the brain more comprehensively, STRIVE-2 newly added imaging features such as cortical cerebral microinfarct and incidental DWI+ lesion. In addition, the STRIVE-2 presents the dilemmas of current researches and the hopes for future research development.

Key words: Cerebral small vessel disease; Consensus; Neuroimaging; Neurodegenerative disease; Microstructure

摘要： 脑小血管病（small vessel disease,SVD）是衰老过程中的常见疾病，可出现卒中、认知障碍、神经心理症状或其他功能损害表现。脑小血管病国际影像标准1（standards for reporting vascular changes on neuroimaging 1，STRIVE-1）对结构MRI上所见的SVD不同影像特征，包括脑白质高信号、血管周围间隙、微出血、近期皮质下小梗死、假定血管源性腔隙和脑萎缩，进行了分类和标准化。随着对SVD影像特征认识的逐渐清晰，以及机器学习方法的迅速兴起，新的SVD研究的神经影像学标准——STRIVE-2已发布。为更全面地反映SVD对大脑的影响，STRIVE-2新增加了脑皮质的微梗死、偶发DWI阳性病灶等影像学特征，同时提出了当前SVD相关研究的困境和未来科研发展的希望。

关键词: 脑小血管病; 共识; 神经影像; 退行性疾病; 微结构