Brinjikji Waleed, Mossa-Basha Mahmud, Huston John, Rabinstein Alejandro A, Lanzino Giuseppe, Lehman Vance T
Department of Radiology, Mayo Clinic, 200, 1st street SW, Rochester, MN 55905, United States.
Department of Radiology, University of Washington, Seattle, WA, United States.
J Neuroradiol. 2017 Mar;44(2):123-134. doi: 10.1016/j.neurad.2016.10.003. Epub 2016 Nov 9.
Cerebrovascular diseases have traditionally been classified, diagnosed and managed based on their luminal characteristics. However, over the past several years, several advancements in MRI techniques have ushered in high-resolution vessel wall imaging (HR-VWI), enabling evaluation of intracranial vessel wall pathology. These advancements now allow us to differentiate diseases which have a common angiographic appearance but vastly different natural histories (i.e. moyamoya versus atherosclerosis, reversible cerebral vasoconstriction syndrome versus vasculitis, stable versus unstable intracranial aneurysms). In this review, we detail the anatomical, histopathological and imaging characteristics of various intracranial steno-occlusive diseases and types of intracranial aneurysms and describe the role that HR-VWI can play in diagnosis, risk stratification and treatment.
传统上，脑血管疾病是根据其管腔特征进行分类、诊断和管理的。然而，在过去几年中，MRI技术的几项进展带来了高分辨率血管壁成像（HR-VWI），能够评估颅内血管壁病变。这些进展现在使我们能够区分具有共同血管造影表现但自然病史差异很大的疾病（即烟雾病与动脉粥样硬化、可逆性脑血管收缩综合征与血管炎、稳定与不稳定颅内动脉瘤）。在本综述中，我们详细阐述了各种颅内狭窄闭塞性疾病和颅内动脉瘤类型的解剖学、组织病理学和影像学特征，并描述了HR-VWI在诊断、风险分层和治疗中所起的作用。
