规范脑小血管病的影像诊断

Normalize the imaging diagnosis of cerebral small vessel disease

脑小血管病(CSVD)的诊断高度依赖神经影像,其影像改变包括腔隙、腔隙性梗死、白质高信号、血管周围间隙、脑微出血等。在既往研究中这些影像改变的定义差异较大,尤其易混淆腔隙、白质高信号、血管周围间隙,给预后评估和临床研究带来困难。文中将总结CSVD的临床、影像、病理特征,梳理CSVD影像改变诊断标准逐渐规范化的过程和成效,提出在CSVD影像诊断中应规避的错误,旨在提高临床诊疗和研究工作的准确性和一致性。

The diagnosis of cerebral small vessel disease(CSVD)is highly dependent on neuroimaging,and its imaging changes include lacune,lacunar infarction,white matter hyperintensity(WMH),perivascular space(PVS),cerebral microbleed,etc.In previous studies,the definitions of these imaging changes were quite different,resulting in misdiagnosis of lacuna,WMH and PVS.This comment will summarize the clinical,imaging,and pathological characteristics of CSVD,sort out the process and effectiveness of the gradually normalized diagnostic standards,and propose errors that should be avoided,aiming to improve the accuracy and consistency of clinical diagnosis and research.