颈动脉粥样硬化斑块无创性高分辨力磁共振成像研究进展

颈动脉粥样硬化性狭窄与脑卒中复发密切相关。目前颈动脉狭窄的治疗方法主要包括药物治疗和外科手术(颈动脉支架成形术和颈动脉内膜切除术)。脑卒中预防在于识别颈动脉狭窄危险因素,筛查脑卒中复发高危患者,从而使其从药物治疗或外科手术中获益,然而目前仅根据颈动脉狭窄程度制定治疗方案,缺乏个体化治疗。近年来,新型影像学技术如无创性高分辨力磁共振成像(HRMRI)等,可以检测出颈动脉易损斑块。与传统数字减影血管造影术测量的颈动脉狭窄程度相比,无创性HRMRI可以根据颈动脉斑块特征准确预测同侧脑卒中风险,从而指导个体化治疗。

Research progress of noninvasive high-resolution magnetic resonance imaging in carotid atherosclerotic plaque

Carotid atheroselerotic stenosis is closely related to recurrent ischemic stroke.Currently,therapies for carotid artery stenosis are mainly intensive medication or surgery,including carotid artery stenting (CAS) and carotid endarterectomy (CEA).The prevention of stroke lies in identifying risk factors for carotid artery stenosis,screening patients with high risk of recurrent stroke,so as to benefit from medication or surgery.However,therapeutic schedule is formulated only according to the degrees of carotid artery stenosis,and there lacks of individualized treatment.Recently,new imaging modalities,such as noninvasive high-resolution MRI (HRMRI) could detect the vulnerability of carotid atherosclerotic plaque.Compared with the degree of carotid artery stenosis measured by conventional DSA,noninvasive HRMRI can precisely predict the risk of ipsilateral stroke according to plaque morphology,so as to guide individualized treatment.