脑小血管病（cerebral small vessel disease,CSVD）是老化的常见伴随疾病,并且常与神经退行性疾病并存,可加剧认知障碍和躯体残疾。由于在CSVD影像学特征术语的命名、定义、影像采集和分析以及科学报告等方面均缺乏一致性,因此阻碍了相关研究的发展。2012年,由全球相关领域的专家组成的神经影像研究专家组发布共识指南,确立了代表CSVD 6种关键性损伤的神经影像标志的术语及其定义,并对影像采集及科学报告的一致性提出了指导意见。这6种CSVD神经影像标志包括近期皮质下小梗死、假定血管源性的腔隙灶、假定血管源性的白质高信号、血管周围间隙、脑微出血和脑萎缩。应在临床实践及相关研究中,充分应用这份共识指南,从而促进CSVD的影像学诊断、影像采集和分析以及科学报告的标准化。
Abstract
Cerebral small vessel disease (CSVD) is a common disease accompanied by aging and is also usually concomitant with neurodegeneration diseases, exacerbating cognitive impairment and physical disability. The lack of consistency of terminology, definition, image acquisition and scientific report of CSVD hampers the further understanding of effects of CSVD on pathophysiological and clinical features of common neurodegenerative diseases. A working group of global research specialists made a comprehensive review of neuroimaging markers of CSVD. The standard of interpretation of terminology and definition of six neuroimaging markers indicating key characteristic manifestations of CSVD, minimum standard for image acquisition and analysis, agreement on scientific reporting of neuroimaging features of CSVD, and new imaging methods for early detection of CSVD, were developed in 2012. These six neuroimaging markers include recent small subcortical infarcts, lacune of presumed vascular origin, white matter hyperintensities of presumed vascular origin, perivascular space, cerebral microbleeds and brain atrophy. The new standard should not be applied only to research work but also to the clinical practice, in order to improve the standardization of interpretation, acquisition and reporting of neuroimaging features of CSVD.
关键词
脑小血管病 /
神经影像 /
磁共振成像 /
标准
Key words
Cerebral small vessel disease /
Neuroimaging /
Magnetic resonance imaging /
Standard
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参考文献
[1] PANTONI L. Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges[J]. Neurol, 2010, 9(7):689-701.
[2] POTTER G M, MARLBOROUGH F J, WARDLAW J M. Wide variation in definition, detection, and description of lacunar lesions on imaging[J]. Stroke, 2010, 42(2):359-366.
[3] HACHINSKI V, IADECOLA C, PETERSEN R C, et al. National Institute of Neurological Disorders and Stroke-Canadian Stroke Network vascular cognitive impairment harmonization standards[J]. Stroke, 2006, 37(9):2220-2241.
[4] GORELICK P B, SCUTERI A, BLACK S E, et al. Vascular contributions to cognitive impairment and dementia: a statement for healthcare professionals from the american heart association/american stroke association[J]. Stroke, 2011, 42(9):2672-2713.
[5] WARDLAW J M, SMITH E E, BIESSELS G J, et al. Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration[J]. Lancet Neurol, 2013, 12(8):822-838.
[6] DOUBAL F N, DENNIS M S, WARDLAW J M. Characteristics of patients with minor ischaemic strokes and negative MRI: a cross-sectional study[J]. J Neurol Neurosurg Psychiatry, 2011, 82(5):540-542.
[7] POTTER G M, DOUBAL F N, JACKSON C A, et al. Counting cavitating lacunes underestimates the burden of lacunar infarction[J]. Stroke, 2010, 41(2):267-272.
[8] MOREAU F, PATEL S, LAUZON M L, et al. Cavitation after acute symptomatic lacunar stroke depends on time, location, and MRI sequence[J]. Stroke, 2012, 43(7):1837-1842.
[9] KOCH S, MCCLENDON M S, BHATIA R. Imaging evolution of acute lacunar infarction: leukoariosis or lacune?[J]. Neurology, 2011, 77(11):1091-1095.
[10] DONNAN G A, BLADIN P F, BERKOVIC S F, et al. The stroke syndrome of striatocapsular infarction[J]. Brain, 1991, 114( Pt 1A):51-70.
[11] FISHER C M. Lacunar strokes and infarcts: a review[J]. Neurology, 1982, 32(8):871-876.
[12] FRANKE C L, VAN SWIETEN J C, VAN GIJN J. Residual lesions on computed tomography after intracerebral hemorrhage[J]. Stroke, 1991, 22(12):1530-1533.
[13] LONGSTRETH W T JR, BERNICK C, MANOLIO T A, et al. Lacunar infarcts defined by magnetic resonance imaging of 3660 elderly people: the Cardiovascular Health Study[J]. Arch Neurol, 1998, 55(9):1217-1225.
[14] GOUW A A, SEEWANN A, VAN DER FLIER W M, et al. Heterogeneity of small vessel disease: a systematic review of MRI and histopathology correlations[J]. J Neurol Neurosurg Psychiatry, 2011, 82(2):126-135.
[15] POLLOCK H, HUTCHINGS M, WELLER R O, et al. Perivascular spaces in the basal ganglia of the human brain: their relationship to lacunes[J]. J Anat, 1997, 191( Pt 3):337-346.
[16] GROESCHEL S, CHONG W K, SURTEES R, et al. Virchow-Robin spaces on magnetic resonance images: normative data, their dilatation, and a review of the literature[J]. Neuroradiology, 2006, 48(10):745-754.
[17] MACLULLICH A M, WARDLAW J M, FERGUSON K J, et al. Enlarged perivascular spaces are associated with cognitive function in healthy elderly men[J]. J Neurol Neurosurg Psychiatry, 2004, 75(11):1519-1523.
[18] BOKURA H, KOBAYASHI S, YAMAGUCHI S. Distinguishing silent lacunar infarction from enlarged Virchow-Robin spaces: a magnetic resonance imaging and pathological study[J]. J Neurol, 1998, 245(2):116-122.
[19] WARDLAW J. Spontaneous brain microbleeds: systematic review, subgroup analyses and standards for study design and reporting[J]. Brain, 2007, 130(Pt 8):1988-2003.
[20] JACK C R JR. Alliance for aging research AD biomarkers work group: structural MRI[J]. Neurobiol Aging, 2011(32 Suppl 1):S48-57.
基金
上海市科学技术委员会资助项目（编号：14411964400）
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