磁共振液体衰减反转恢复序列高信号血管征在急性缺血性卒中诊疗中的应用价值

The Value of FLAIR Hyperintense Vascular Sign in the Diagnosis and Treatment of AcuteIschemic Stroke

头颅MRI F LAIR序列高信号血管征(hyperintense v essel s ign,HVS)表现为大脑中动脉近端点状或条状,外侧裂远端线形或蛇形的高信号影。HVS的形成与颅内大动脉严重狭窄或闭塞所致侧支循环血液顺向或逆向缓慢流动有关。目前研究认为HVS可以作为颅内大血管狭窄或闭塞的标志物,且提示患者存在良好的脑侧支循环。另外,基线HVS-DWI不匹配可以用来筛选能从再灌注治疗中获益的缺血性卒中患者。对于未进行再灌注治疗的缺血性卒中患者,HVS与其预后的关系目前存在较大争议。多种临床因素,特别是发病至影像检查的时间都能影响HVS的显像,应结合临床特点对其结果进行综合判断。

Head magnetic resonance FLAIR hyperintense vessel sign(HVS)is a FLAIR hyperintensity sign in the shape of dots or strips in the proximal middle cerebral artery,or linear or serpentine in the lateral fissure.HVS is associated with slow antegrade or retrograde blood flow in the collateral circulation due to intracranial large artery severe stenosis or occlusion.Current studies suggested that HVS can be a imaging marker of intracranial large vessel stenosis or occlusion,indicating the presence of good cerebral collateral circulation.For patients with acute ischemic stroke,baseline HVS-DWI mismatch can be used for screening eligible patients who would benefit from reperfusion therapy;However,the relationship between HVS and prognosis in patients who do not undergo reperfusion therapy is currently controversial.A variety of clinical factors,especially the time from onset to imaging,can affect the imaging of HVS,therefore,the imaging results should be judged comprehensively with reference to clinical features.