Extracranial Vascular Disease: Carotid Stenosis and Plaque Imaging.
Extracranial Vascular Disease: Carotid Stenosis and Plaque Imaging.
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DOI：
10.1016/j.nic.2021.02.002
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发表时间：
2021-05
影响因子：
2.3
通讯作者：
Gupta, Ajay
中科院分区：
文献类型：
--
作者：
Baradaran, Hediyeh;Gupta, Ajay
中风是全世界发病和死亡的主要原因，其中颈动脉粥样硬化是导致缺血性中风的重要原因。 1, 2 颅外颈动脉疾病的详细影像学评估对于脑血管缺血患者的适当风险分层和管理至关重要。当颈动脉粥样硬化成像时，两个重要因素是管腔狭窄程度和斑块成分的评估。管腔狭窄一直是患者参与多项随机卒中预防试验的基础，这些研究的结果将狭窄严重程度确立为基于影像学的颈动脉疾病风险分层的主要方法。 3-6 然而，最近越来越多的证据表明单个斑块成分对易损颈动脉斑块的贡献对单独管腔狭窄测量作为中风风险评估首选影像生物标志物的首要地位提出了挑战。管腔狭窄和颈动脉斑块的成像可以通过多种技术进行，包括超声、数字减影血管造影、CT 血管造影和高分辨率 MR。准确描述管腔狭窄和斑块特征是颅外颈动脉成像的主要目标，也是本次综述的重点。
Stroke is a major cause of morbidity and mortality worldwide, with carotid atherosclerosis contributing to a significant proportion of ischemic strokes. 1, 2 Detailed imaging assessment of extracranial carotid artery disease is critical for the appropriate risk stratification and management of those presenting with cerebrovascular ischemia. When imaging carotid atherosclerosis, the two important factors are the degree of luminal stenosis and the assessment of plaque components. Luminal stenosis has been the basis for patient inclusion in multiple randomized stroke prevention trials and the results of these studies established stenosis severity as the primary imaging-based method for carotid disease risk stratification. 3–6 However, recent mounting evidence of the contribution of individual plaque components to vulnerable carotid plaque has challenged the primacy of luminal stenosis measures alone as the imaging biomarker of choice for stroke risk assessment. Imaging of luminal stenosis and carotid plaque can be performed with a number of techniques including ultrasound, digital subtraction angiography, CT angiography, and high-resolution MR. Accurate characterization of both luminal stenosis and plaque characteristics is the primary objective of imaging the extracranial carotid artery and will be the focus of this review.
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