Advanced imaging modalities in the detection of cerebral vasospasm.
Advanced imaging modalities in the detection of cerebral vasospasm.
复制标题
检测脑血管痉挛的先进成像方式。
DOI：
10.1155/2013/415960
复制
发表时间：
2013
影响因子：
1.5
通讯作者：
Mack,WilliamJ
中科院分区：
文献类型：
--
作者：
Mills,JenaN;Mehta,Vivek;Russin,Jonathan;Amar,ArunP;Rajamohan,Anandh;Mack,WilliamJ
动脉瘤性蛛网膜下腔出血（SAH）后脑血管痉挛的病理生理学是复杂的，尚未完全了解。通过诊断成像能力的进步，已经获得了机制上的见解。核心技术集中于评估血管口径、组织代谢和/或局部灌注参数。影像学的进步为临床医生提供了一个多方面的方法来帮助检测脑血管痉挛和诊断迟发性缺血性神经功能缺陷（ddd）。然而，一种具有广泛功效的单一测试或算法仍然难以捉摸。本文探讨了适用于SAH后血管痉挛的解剖和生理成像模式，并提供了历史背景。我们考虑经颅多普勒超声（TCD）测量的脑血流速度。结构成像技术，包括基于导管的数字减影血管造影（DSA）， CT血管造影（CTA）和MR血管造影（MRA），进行了综述。我们通过PET， HMPAO SPECT，133Xe清除率，氙增强CT (Xe/CT)，灌注CT （PCT）和扩散加权/MR灌注成像检查生理评估。讨论了比较优势和局限性。
The pathophysiology of cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH) is complex and is not entirely understood. Mechanistic insights have been gained through advances in the capabilities of diagnostic imaging. Core techniques have focused on the assessment of vessel caliber, tissue metabolism, and/or regional perfusion parameters. Advances in imaging have provided clinicians with a multifaceted approach to assist in the detection of cerebral vasospasm and the diagnosis of delayed ischemic neurologic deficits (DIND). However, a single test or algorithm with broad efficacy remains elusive. This paper examines both anatomical and physiological imaging modalities applicable to post‐SAH vasospasm and offers a historical background. We consider cerebral blood flow velocities measured by Transcranial Doppler Ultrasonography (TCD). Structural imaging techniques, including catheter‐based Digital Subtraction Angiography (DSA), CT Angiography (CTA), and MR Angiography (MRA), are reviewed. We examine physiologic assessment by PET, HMPAO SPECT,133Xe Clearance, Xenon‐Enhanced CT (Xe/CT), Perfusion CT (PCT), and Diffusion‐Weighted/MR Perfusion Imaging. Comparative advantages and limitations are discussed.