SWI脑微出血征临床相关研究进展

Clinical progress of SWI cerebral microbleeds

脑微出血(CMBs)常见于卒中等脑血管疾病患者,是较为常见的神经影像征象。CMBs的病理生理过程以及发生机制尚未完全明确,可能继发于慢性高血压血管壁损伤或组织淀粉样蛋白沉积。CMBs的存在增加了卒中、痴呆和死亡的风险,随着CMBs数量的增加,溶栓、抗凝或抗血小板等治疗可能会导致急性缺血性卒中(AIS)患者出血并发症的风险增加,然而,CMBs的存在并不是抗凝或溶栓的用药禁忌。磁敏感加权成像(SWI)依靠其对血液成分、钙化、铁沉积等显示优势,在AIS等脑血管疾病的诊断及评估中发挥着独特作用。本文就目前对SWI脑微出血的认识及其在AIS治疗的评估价值进行综述。

Cerebral microbleeds(CMBs)are common neuroimaging signs in patients with cerebrovascular diseases such as stroke.The pathophysiological process and pathogenesis of CMBs have not been completely clarified,and may be secondary to vascular wall damage or tissue amyloid deposition in chronic hypertension.The presence of CMBs increases the risk of stroke,dementia,and death.As the number of CMBs increases,thrombolytic,anticoagulant,or antiplatelet therapies may increase the risk of bleeding complications in patients with acute ischemic stroke(AIS).However,the presence of CMBs is not a contraindication for anticoagulant or thrombolytic therapy.Susceptibility weighted imaging(SWI)plays a unique role in the diagnosis and evaluation of cerebrovascular diseases such as AIS due to its advantages in showing blood composition,calcification and iron deposition.This article reviews the current natural understanding of magnetic sensitivity weighted imaging of CMBs and its application in AIS treatment evaluation.