Imaging Evaluation of Cerebral Collateral Circulation

Abstract

Abstract:

Ischemic cerebrovascular disease is a common and frequently-occurring disorder harming human health. With improvement of people's living standard, incidence rate of the disease is increasing. The key to treat the patients with ischemic cerebrovascular disease is to improve and recover cerebral perfusion, and the cerebral collateral circulation plays an important role in this tache. The imaging evaluation of cerebral collateral circulation contribution is the key to choose the best treatment. The golden standard of evaluating the cerebral collateral circulation is digital subtraction angiography (DSA), which can show the distribution of the collateral vessels clearly. Considering the invasiveness of DSA, we also can choose transcranial Doppler (TCD) to measure the blood velocity of collateral circulation vessles, determine the direction of blood, computed tomography angiography (CTA) to observe the intracranial blood vessels dynamically from any angle and magnetic resonance imaging (MRI) to show all the main blood vessels and their branches. Because of the limitation of all these techniques, knowledge of the merits and demerits about these techniques is important for a reasonable choice, we will discuss these aspects in this review.

Key words: Collateral circulation; Digital subtraction angiography; Computed tomography angiography; Magnetic resonance imaging

摘要：

缺血性脑血管病是危害人类健康的常见病和多发病，随着人们生活水平的提高，发病率也逐年提高。改善和恢复缺血区的血流灌注是治疗缺血性脑血管病的关键，而良好的侧支循环情况在此环节发挥着重要作用。对于如何选择最佳的治疗方案以构建良好的侧支循环，系统的影像学评估是关键。全脑数字减影血管造影术（digital subtraction angiography，DSA）是评估侧支循环的金标准，能够清晰地显示出侧支血管的分布和所代偿的供血区域，若碍于其有创性，可考虑选择无创技术：经颅多普勒超声（transcranial Doppler，TCD）测量侧支循环血管的血流流速、确定血流的方向等，计算机断层扫描血管造影（computed tomography angiography，CTA）从任何角度动态观察颅内的血管和磁共振成像（magnetic resonance imaging，MRI）显示成像范围内的全部主要的血管及其分支，但各种技术均存在局限性，掌握各评估技术的优缺点对于做出合理的联合选择非常重要，本文对此展开综述。

关键词: 侧支循环; 数字减影血管造影术; 计算机断层扫描血管造影; 磁共振成像

LI Qian-Lu, YANG De-Yu, LIU Bo, LI Zhi-Wei.. Imaging Evaluation of Cerebral Collateral Circulation[J]. Chinese Journal of Stroke, 2015, 10(02): 175-180.

李乾露，杨德雨，刘波，李志伟. 脑供血侧支循环的影像学评估[J]. 中国卒中杂志, 2015, 10(02): 175-180.

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