Jia Ze-Jun, Zhao Rui, Yang Zhi-Gang, Huang Qin-Hai, Deng Xiao-Qun, Hong Bo, Liu Jian-Min
Department of Neurosurgery, Changhai Hospital, Journal of Second Military Medical University, Shanghai 200433, Chinas.
Nan Fang Yi Ke Da Xue Xue Bao. 2015 Jan;35(1):154-9.
Intracranial atherosclerotic disease (ICAD) of a major intracranial artery, including middle cerebral artery (MCA),basilar artery, is the most common causes of stroke and is associated with a high risk of recurrent stroke in China. The difficulty to treatment these high-risk disease is to identify high-risk stroke subgroups and to develop more effective treatments (aggressive medical therapy/endovascular therapy). With the benefits, including non-invasive, in vivo, and no-ionizing radiation, 3.0 Tesla high-resolution magnetic resonance imaging (HR MRI) could be used to stratify high-risk patients, monitor progression of disease, and evaluate clinical efficacy, based on MCA wall structure and plaque characteristic. HR MRI has the latency of predicting high-risk patients benefit from endovascular therapy, having a broad application prospect during psot-SAMMPRIS era. The current research on MCA stenosis using HR MRI focuses on methodoiogy, diagnosis and differential diagnosis, etiology, and lacks of clinical efficiency evaluation and prognostic analysis of ICAD treatment, especially lacks the research on in-stent restenosis, which needs further investigation.
主要颅内动脉（包括大脑中动脉、基底动脉）的颅内动脉粥样硬化疾病（ICAD）是中国中风最常见的病因，且与复发性中风的高风险相关。治疗这些高危疾病的难点在于识别高危中风亚组并开发更有效的治疗方法（积极的药物治疗/血管内治疗）。3.0特斯拉高分辨率磁共振成像（HR MRI）具有非侵入性、体内成像且无电离辐射等优点，可基于大脑中动脉壁结构和斑块特征对高危患者进行分层、监测疾病进展并评估临床疗效。HR MRI在预测高危患者从血管内治疗中获益方面具有潜力，在SAMMPRIS时代后的时期具有广阔的应用前景。目前利用HR MRI对大脑中动脉狭窄的研究集中在方法学、诊断与鉴别诊断、病因学等方面，缺乏对ICAD治疗的临床疗效评估和预后分析，尤其是缺乏对支架内再狭窄的研究，这需要进一步探讨。
