急性缺血性卒中磁敏感血管征影响因素及临床应用的研究进展 Research Progress on Factors Related to the Susceptibility Vessel Sign and its Clinical Application in Acute Ischemic Stroke

Abstract

治疗时间窗内静脉溶栓及血管内治疗因可以降低急性缺血性卒中患者死亡率和致残率，是各国急性缺血性卒中指南推荐的Ⅰa级证据，但可能会引起血管再通失败和较严重的并发症。磁敏感血管征是T2*WI或SWI上，责任血管走行区域出现的低信号血管影。这种成像可以反映含铁血黄素含量，对血栓高度敏感。因此，磁敏感血管征可用于推测急性缺血性卒中亚型、血栓负荷、症状发作时间，以及与血管成功再通相关的因素。这有助于指导缺血性卒中超急性期治疗方案的选择，评估疗效和减少不良预后的发生。由于磁敏感血管征的影响因素较多，其临床应用一直存在争议。本文对磁敏感血管征的影响因素，如症状发作时间、卒中亚型、血栓位置、MRI扫描仪和磁敏感血管征临床应用予以综述。 Abstract: Intravenous thrombolysis and endovascular treatment in the treatment time window can reduce the mortality and disability rate of patients with acute ischemic stroke (AIS), which is the level Ⅰa evidence recommended by the national guidelines for AIS, but may cause revascularization failure and more serious complications. Susceptibility vessel sign (SVS) is defined as the presence of hypointensity in the area of the responsible vessel on T2*WI or SWI scans. The SVS reflects the hemosiderin content and is highly sensitive to thrombus. Therefore, SVS can be used to infer the subtype of AIS, the thrombus burden, the symptom onset time, and other factors associated with successful revascularization. It is helpful to guide the selection of treatment for hyperacute ischemic stroke, assess the efficacy of treatment, and reduce the occurrence of poor prognosis. The clinical application of SVS has been controversial because there are many factors affecting it. This paper reviewed the influencing factors, such as the symptom onset time, stroke subtype, thrombus location, MRI scanner, and the clinical application of SVS.

Keywords

• 急性缺血性卒中
• 超急性期治疗
• 磁敏感加权成像
• 磁敏感血管征
• 血管再通
• 影响因素
• acute ischemic stroke
• hyperacute phase therapy
• susceptibility weighted imaging
• susceptibility vessel sign
• revascularization
• influencing factor