From Vascular Imaging to Cerebral Function Assessment: Research Advances in Cervicocephalic Vascular Ultrasound in the Full-Course Management of Stroke

doi:10.3969/j.issn.1673-5765.2026.08.001

Abstract

Abstract: Cervicocephalic vascular ultrasound is a widely used non-invasive imaging modality in stroke care. With advances in TCD, contrast-enhanced ultrasound, and cerebral autoregulation assessment, its role has evolved from a single-purpose vessel morphology screening tool into a multidimensional diagnostic and therapeutic system encompassing etiological classification, risk stratification, real-time treatment monitoring, and prognostic evaluation. This review systematically summarizes the technical evolution of core cervicocephalic ultrasound modalities and highlights their clinical applications in cerebral autoregulation assessment, cryptogenic stroke workup, carotid plaque vulnerability stratification, real-time monitoring during reperfusion therapy, and dynamic management of vasospasm following subarachnoid hemorrhage. Current limitations—including inadequate temporal acoustic windows, operator dependency, and lack of standardization in functional techniques—are discussed, and future directions in multimodal image fusion, AI-assisted diagnosis, and integrated diagnosis-therapy platforms are outlined.

Key words: Transcranial Doppler; Carotid ultrasound; Cerebral autoregulation; Contrast-enhanced ultrasound; Stroke

摘要： 头颈血管超声是卒中诊疗中应用广泛的无创影像工具。随着TCD、超声造影及脑血流自动调节检测等技术的发展，其角色已从单一的血管形态筛查扩展为覆盖病因分型、风险分层、治疗监测与预后评估的多维度诊疗体系。本文系统回顾了头颈血管超声的发展脉络，重点阐述了其在脑血流自动调节功能评估、隐源性卒中病因识别、颈动脉斑块易损性分层、再灌注治疗实时监测及蛛网膜下腔出血后血管痉挛动态管理中的应用进展。此外，本文还分析了颅骨声窗限制、操作者依赖性及功能学技术标准化不足等当前局限，并从多模态影像融合、人工智能辅助诊断及诊疗一体化等方向展望了头颈血管超声未来发展路径。

关键词: 经颅多普勒; 颈动脉超声; 脑血流自动调节; 超声造影; 卒中

CLC Number:

WANG Haili, CAO Liming, GUO Zhenni, YANG Yi, REN Lijie. From Vascular Imaging to Cerebral Function Assessment: Research Advances in Cervicocephalic Vascular Ultrasound in the Full-Course Management of Stroke[J]. Chinese Journal of Stroke, 2026, 21(8): 921-927.

王海丽, 曹黎明, 郭珍妮, 杨弋, 任力杰. 从血管成像到脑功能评估：头颈血管超声在卒中全程管理中的应用进展[J]. 中国卒中杂志, 2026, 21(8): 921-927.

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URL: https://www.chinastroke.org.cn/EN/10.3969/j.issn.1673-5765.2026.08.001

https://www.chinastroke.org.cn/EN/Y2026/V21/I8/921

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