Advances in Research on Evaluation of Cerebral Collateral Circulation

doi:10.12114/j.issn.1007-9572.2019.00.305

Abstract

Abstract: Cerebral infarction is the most common type of stroke in China characterized by high incidence and mortality rate.Collateral circulation refers to a network of small arteries that connect adjacent arterial groups.The establishment of collateral circulation is closely related to the prognosis of patients with cerebral infarction.Good collateral circulation is essential for maintaining normal cerebral perfusion and cerebral blood flow after cerebral ischemia，and reducing the size of infarct and ischemic penumbra.There are various methods for evaluating collateral circulation，including transcranial Doppler，computed tomography angiography，computed tomography perfusion，magnetic resonance angiography，fluid-attenuated inversion recovery，arterial spin labeling，permeability imaging，digital subtraction angiography（DSA），etc.In particular，DSA is a recognized gold standard for evaluating collateral circulation.This article reviews the recent research progress of various collateral circulation evaluation methods，and finds that there are advantages and disadvantages in various evaluation methods.Clinical doctors should always consider patients' condition and choose appropriate evaluation tools.

Key words: Collateral circulation, Brain infarction, Digital subtract angiography, Transcranial doppler, Computed tomography angiography

摘要： 脑梗死是我国最常见的脑卒中类型，其发病率、病死致残率高。侧支循环是指连接相邻动脉群的细小动脉网络。侧支循环的建立和脑梗死患者预后密切相关。良好的侧支循环对于脑缺血发生后维持正常的脑灌注和脑血流，减少梗死面积和缺血半暗带至关重要。评价侧支循环的方法多种多样，包括经颅多普勒彩超（TCD）、CT血管造影（CTA）、CT灌注成像（CTP）、磁共振血管成像（MRA）、流体衰减恢复信号（FLAIR）、动脉自旋标记（ASL）、通透性影像、数字减影血管成像（DSA）等，尤以DSA为评价侧支循环公认的金标准。本文就近期多种脑血管侧支循环的评价方式的研究进展进行综述，发现多种评价方式各有利弊，临床一线医生应综合考虑患者病情，选择恰当的评价工具。

关键词: 侧支循环, 脑梗死, 数字减影血管成像, 经颅多普勒彩超, CT血管造影

CHU Bao,ZHANG Jijie,DONG Lipeng, et al. Advances in Research on Evaluation of Cerebral Collateral Circulation　[J]. Chinese General Practice, 2020, 23(5): 516-524. DOI: 10.12114/j.issn.1007-9572.2019.00.305.
楚宝,张继杰,董立朋等. 脑血管侧支循环评价的研究进展[J]. 中国全科医学, 2020, 23(5): 516-524. DOI: 10.12114/j.issn.1007-9572.2019.00.305.

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