颅外和颅内血管系统的横断面成像在不明来源栓塞性卒中中的作用。

The role of cross-sectional imaging of the extracranial and intracranial vasculature in embolic stroke of undetermined source.

作者信息

Baradaran Hediyeh, Kamel Hooman, Gupta Ajay

机构信息

Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, United States.

Department of Neurology, Weill Cornell Medicine, New York, NY, United States.

出版信息

Front Neurol. 2022 Aug 26;13:982896. doi: 10.3389/fneur.2022.982896. eCollection 2022.

Abstract

Despite an extensive workup, nearly one third of ischemic strokes are defined as Embolic Stroke of Undetermined Source (ESUS), indicating that no clear etiologic cause has been identified. Since large vessel atherosclerotic disease is a major cause of ischemic stroke, we focus on imaging of large vessel atherosclerosis to identify further sources of potential emboli which may be contributing to ESUS. For a stroke to be considered ESUS, both the extracranial and intracranial vessels must have <50% stenosis. Given the recent paradigm shift in our understanding of the role of plaque vulnerability in ischemic stroke risk, we evaluate the role of imaging specific high-risk extracranial plaque features in non-stenosing plaque and their potential contributions to ESUS. Further, intracranial vessel-wall MR is another potential tool to identify non-stenosing atherosclerotic plaques which may also contribute to ESUS. In this review, we discuss the role of cross-sectional imaging of the extracranial and intracranial arteries and how imaging may potentially uncover high risk plaque features which may be contributing to ischemic strokes.

摘要

尽管进行了广泛的检查,但近三分之一的缺血性中风被定义为不明来源栓塞性中风(ESUS),这表明尚未确定明确的病因。由于大血管动脉粥样硬化疾病是缺血性中风的主要原因,我们专注于大血管动脉粥样硬化的成像,以识别可能导致ESUS的潜在栓子的进一步来源。对于被认为是ESUS的中风,颅外和颅内血管的狭窄程度都必须<50%。鉴于我们对斑块易损性在缺血性中风风险中的作用的理解最近发生了范式转变,我们评估了成像特定的颅外高危斑块特征在非狭窄斑块中的作用及其对ESUS的潜在贡献。此外,颅内血管壁磁共振成像(MR)是识别可能也导致ESUS的非狭窄动脉粥样硬化斑块的另一种潜在工具。在这篇综述中,我们讨论了颅外和颅内动脉横断面成像的作用,以及成像如何可能揭示可能导致缺血性中风的高危斑块特征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b209/9459011/1f189152b698/fneur-13-982896-g0001.jpg

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索