穿支动脉粥样硬化性疾病的诊治进展

Advances in Branch Atheromatous Disease

穿支动脉粥样硬化性疾病(branch atheromatous disease,BAD)是引起急性孤立性皮层下梗死的常见且重要的病因,尤以亚洲人群多见。与脑小血管病所致腔隙性梗死比较,BAD相关梗死灶直径、形态学分布具有一定的特征性。BAD相关卒中急性期更易出现症状波动或神经功能恶化,早期预后不良。目前BAD仍缺乏统一的临床影像诊断标准,使得BAD临床研究及精准诊疗面临挑战。近期应用高分辨及高场强磁共振技术可同时显示载体动脉管壁和穿支动脉形态,未来有望突破BAD的发病机制研究的瓶颈。本文对BAD临床影像特征、诊断标准及防治策略等进行综述,以期提高临床医师的重视和认知水平。

Branch atheromatous disease(BAD),was supposed as one of the important etiology for acute isolated subcortical infarction,especially in Asian population.Compared with classic lacuna infarction due to cerebral small vessel disease,the diameter and morphological distribution of BAD related infarction have certain characteristics.Patients with BAD are more liable to have a fluctuating symptoms or experience early neurological deterioration and may have early poor prognosis.However,due to the fact that the existing imaging techniques cannot depict small vessel changes,the clinical diagnosis and research of BAD are facing challenges.Recently,the application of high resolution and high field magnetic resonance imaging can simultaneously depict the vessel wall of parent artery and the morphology of penetrating artery,which is expected to break through the bottleneck of the research on pathogenesis of BAD.This article reviewed the clinical and imaging features of BAD,diagnosis standards and treatment strategy for BAD,to raise the awareness of this disease for neurologists.