慢性颈内动脉闭塞的影像学评价与治疗研究进展

Advances in imaging evaluation and treatment for chronic internal carotid artery occlusion

慢性颈内动脉闭塞(ICAO)可导致缺血性卒中。既往主要通过形态学影像来对ICAO进行评价,其对ICAO患者的卒中风险预测帮助有限。新兴的脑血管侧支循环和脑血流储备的影像学评价方法以及高分辨率MR管壁成像等能协助临床医师对ICAO患者进行卒中的风险分层。目前针对慢性症状性ICAO的治疗仍存在争议,颅内外动脉旁路移植术、血管内介入再通、复合手术再通等多种策略各有优势。作者对慢性ICAO的影像学评价手段和治疗方式进行综述,以期为该病的预防和治疗提供参考。

Chronic internal carotid artery occlusion(ICAO)may cause an ischemic stroke.ICAO was mainly evaluated by morphological imaging,which had limited assistance in predicting stroke risk of ICAO patients.The emerging diagnostic techniques for evaluating cerebrovascular collateral circulation and cerebrovascular reserve like the high-resolution vessel wall magnetic resonance imaging technique,could help clinicians to stratify stroke risks for ICAO patients.The treatment of symptomatic ICAO is still controversial at present.A variety of therapeutic strategies such as extracranial-intracranial artery bypass surgery,endovascular interventional recanalization,and hybrid surgical recanalization have their respective advantages.The article reviewed the imaging evaluation techniques and treatment strategies for chronic ICAO and expected to provide references for the prevention and treatment of the disease.