Brain imaging biomarkers of carotid artery disease.
Brain imaging biomarkers of carotid artery disease.
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DOI：
10.21037/atm-20-1939
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发表时间：
2020-10
影响因子：
--
通讯作者：
Gupta A
中科院分区：
文献类型：
--
作者：
Baradaran H;Gupta A
颅外颈动脉粥样硬化性疾病是缺血性卒中的主要原因。颈动脉粥样硬化性疾病可以表现为一系列的表现，从轻度颈动脉内膜中层厚度到高危颈动脉易损斑块特征和颈动脉狭窄。在导致临床上明显的中风或短暂性脑缺血发作之前，可能存在颈动脉粥样硬化疾病继发的下游缺血的其他标志物。在这篇综述文章中，我们将回顾一些可能在颈动脉疾病下游的各种影像学表现，包括在CT、MR或其他先进影像学技术上可能看到的血流动力学和灌注异常，脑成像上的白色高信号，无症状或隐性脑梗死，脑微出血，以及局部和全身性脑容量损失。这些影像学表现中的许多在没有明显临床症状的患者的脑磁共振成像中常见。尽管经常是无症状的，但这些影像学发现中的许多也与未来中风、认知障碍甚至死亡率的风险增加密切相关。我们将回顾现有的证据支持这些常见的影像学表现和颈动脉粥样硬化性疾病之间的关联。这些影像学发现的未来验证可能导致它们成为脑血管健康的有力生物标志物。
Extracranial carotid artery atherosclerotic disease is a major contributor to ischemic stroke. Carotid atherosclerotic disease can present with a spectrum of findings ranging from mild carotid intima-media thickness to high-risk vulnerable carotid plaque features and carotid stenosis. Before leading to clinically overt stroke or transient ischemic attack, there may be other markers of downstream ischemia secondary to carotid atherosclerotic disease. In this review article, we will review some of the imaging findings that may be seen downstream to carotid artery disease on various imaging modalities, including hemodynamic and perfusional abnormalities which may be seen on CT, MR, or using other advanced imaging techniques, white matter hyperintensities on brain imaging, silent or covert brain infarctions, cerebral microbleeds, and regional and generalized cerebral volume loss. Many of these imaging findings are seen routinely on brain magnetic resonance imaging in patients without overt clinical symptoms. Despite frequently being asymptomatic, many of these imaging findings are also strongly associated with increased risk of future stroke, cognitive impairment, and even mortality. We will review the existing evidence underpinning the associations between these frequently encountered imaging findings and carotid artery atherosclerotic disease. Future validation of these imaging findings could lead to them being powerful biomarkers of cerebrovascular health.
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DOI：
10.1136/bmj.c3666
发表时间：
2010-07-26
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Debette S;Markus HS
通讯作者：
Markus HS
影响因子：
2.4
作者：
Chung, Pil-Wook;Park, Kwang-Yeol;Ha, Sam-Yeol
通讯作者：
Ha, Sam-Yeol
影响因子：
19.7
作者：
Bokkers, Reinoud P. H.;van Osch, Matthias J. P.;Hendrikse, Jeroen
通讯作者：
Hendrikse, Jeroen
影响因子：
9.9
作者：
Brisset, Marion;Boutouyrie, Pierre;Debette, Stephanie
通讯作者：
Debette, Stephanie
影响因子：
8.3
作者：
Baradaran, Hediyeh;Gialdini, Gino;Gupta, Ajay
通讯作者：
Gupta, Ajay