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脑血管形态学:对正常变异、衰老影响及疾病意义的洞察

Cerebrovascular morphology: Insights into normal variations, aging effects, and disease implications.

作者信息

Deshpande Aditi, Zhang Lucy Q, Balu Ramani, Yahyavi-Firouz-Abadi Noushin, Badjatia Neeraj, Laksari Kaveh, Tahsili-Fahadan Pouya

机构信息

Department of Mechanical Engineering, University of California, Riverside, USA.

Department of Neurology, Duke University School of Medicine, Durham, NC, USA.

出版信息

J Cereb Blood Flow Metab. 2025 May 2:271678X251328537. doi: 10.1177/0271678X251328537.

Abstract

Cerebrovascular morphology plays a critical role in brain health, influencing cerebral blood flow (CBF) and contributing to the pathogenesis of various neurological diseases. This review examines the anatomical structure of the cerebrovascular network and its variations in healthy and diseased populations and highlights age-related changes and their implications in various neurological conditions. Normal variations, including the completeness and anatomical anomalies of the Circle of Willis and collateral circulation, are discussed in relation to their impact on CBF and susceptibility to ischemic events. Age-related changes in the cerebrovascular system, such as alterations in vessel geometry and density, are explored for their contributions to age-related neurological disorders, including Alzheimer's disease and vascular dementia. Advances in medical imaging and computational methods have enabled automatic quantitative assessment of cerebrovascular structures, facilitating the identification of pathological changes in both acute and chronic cerebrovascular disorders. Emerging technologies, including machine learning and computational fluid dynamics, offer new tools for predicting disease risk and patient outcomes based on vascular morphology. This review underscores the importance of understanding cerebrovascular remodeling for early diagnosis and the development of novel therapeutic approaches in brain diseases.

摘要

脑血管形态在脑健康中起着关键作用,影响脑血流量(CBF)并促成各种神经疾病的发病机制。本综述探讨了脑血管网络的解剖结构及其在健康人群和患病群体中的变化,并强调了与年龄相关的变化及其在各种神经疾病中的影响。讨论了正常变异,包括 Willis 环的完整性和解剖异常以及侧支循环,及其对 CBF 和缺血事件易感性的影响。探讨了脑血管系统中与年龄相关的变化,如血管几何形状和密度的改变,及其对包括阿尔茨海默病和血管性痴呆在内的与年龄相关的神经疾病的影响。医学成像和计算方法的进展使得能够对脑血管结构进行自动定量评估,有助于识别急性和慢性脑血管疾病中的病理变化。包括机器学习和计算流体动力学在内的新兴技术为基于血管形态预测疾病风险和患者预后提供了新工具。本综述强调了了解脑血管重塑对于脑部疾病的早期诊断和新治疗方法开发的重要性。

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