[1]陆悦新,王明,万曙.光学相干断层成像在颅内动脉粥样硬化性狭窄诊疗中的应用进展[J].介入放射学杂志,2025,34(01):103-108.
 LU Yuexin,WANG Ming,WAN Shu..Advances in the application of optical coherence tomography in the diagnosis and treatment of intracranial atherosclerotic stenosis[J].journal interventional radiology,2025,34(01):103-108.
点击复制

光学相干断层成像在颅内动脉粥样硬化性狭窄诊疗中的应用进展()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
34
期数:
2025年01
页码:
103-108
栏目:
综述
出版日期:
2025-01-22

文章信息/Info

Title:
Advances in the application of optical coherence tomography in the diagnosis and treatment of intracranial atherosclerotic stenosis
作者:
陆悦新王明万曙
Author(s):
LU YuexinWANG MingWAN Shu.
The Second Clinical Medical College,Zhejiang University of Traditional Chinese Medicine,Hangzhou,Zhejiang Province 310000,China
关键词:
【关键词】颅内动脉粥样硬化性狭窄光学相干断层成像血流动力学卒中
文献标志码:
A
摘要:
【摘要】颅内动脉粥样硬化性狭窄(intracranial atherosclerotic stenosis,ICAS)是亚洲人群缺血性脑卒中最常见的病因之一。预测ICAS患者卒中发生风险并进行卒中风险分层,有助于临床医生早期采取干预措施改善患者预后。光学相干断层成像(optical coherence tomography,OCT)是一种新型超高分辨率的血管内实时成像技术,在评估动脉粥样硬化斑块特征和管腔形态学方面具有多重优势,特别是在揭示易损斑块的微细结构特征方面,为评估斑块稳定性提供了强有力的图像支持;结合血流动力学评估,判断斑块形成与发展趋势,对预测ICAS患者卒中复发风险、指导个体化介入治疗具有重要意义。该文旨在对OCT及其结合血流动力学评估应用于ICAS诊疗的最新研究进展进行综述,展望OCT在脑血管领域的应用前景,为ICAS患者的风险评估、疾病监测和治疗决策提供科学依据。

参考文献/References:

[1]Wang D,Liu J,Liu M,et al.Patterns of stroke between university hospitals and nonuniversity hospitals in mainland China:prospective multicenter hospital-based registry study[J].World Neurosurg,2017,98:258-265.
[2]Ma Y,Wang T,Wang H,et al.Extracranial-intracranial bypass and risk of stroke and death in patients with symptomatic artery occlusion:the CMOSS randomized clinical trial[J].JAMA,2023,330:704-714.
[3]Bang OY,Kim BM,Seo WK,et al.Endovascular therapy for acute ischemic stroke of intracranial atherosclerotic origin-neuroimaging perspectives[J].Front Neurol,2019,10:269.
[4]Elhfnawy AM,Heuschmann PU,Pham M,et al.Stenosis length and degree interact with the risk of cerebrovascular events related to internal carotid artery stenosis[J].Front Neurol,2019,10:317.
[5]Wang Y,Zhao X,Liu L,et al.Prevalence and outcomes of symptomatic intracranial large artery stenoses and occlusions in China:the Chinese Intracranial Atherosclerosis (CICAS) Study[J].Stroke,2014,45:663-669.
[6]Gutierrez J,Turan TN,Hoh BL,et al.Intracranial atherosclerotic stenosis:risk factors,diagnosis,and treatment[J].Lancet Neurol,2022,21:355-368.
[7]Tang M,Gao J,Ma N,et al.Radiomics nomogram for predicting stroke recurrence in symptomatic intracranial atherosclerotic stenosis[J].Front Neurosci,2022,16:851353.
[8]Barnard ZR,Alexander MJ.Update in the treatment of intracranial atherosclerotic disease[J].Stroke Vasc Neurol,2020,5:59-64.
[9]Xu R,Zhao Q,Wang T,et al.Optical coherence tomography in cerebrovascular disease:open up new horizons[J].Transl Stroke Res,2023,14:137-145.
[10]Li L,Dmytriw A,Krings T,et al.Visualization of the human intracranial Vasa vasorum in vivo using optical coherence tomography[J].JAMA Neurol,2020,77:903-905.
[11]Yang B,Feng Y,Ma Y,et al.Frequency-domain optical coherence tomography for intracranial atherosclerotic stenosis:feasibility,safety,and preliminary experience[J].Front Neurol,2021,12:678443.
[12]房超,于波.光学相干断层成像在评价冠状动脉钙化中的应用[J].心血管康复医学杂志,2019,28:513-516.
[13]石潆,宋凯,赵卫.光学相干断层成像技术在颈部及颅内血管检查和介入治疗中应用研讨[J].介入放射学杂志,2015,24:177-181.
[14]Mathews MS,Su J,Heidari E,et al.Neuroendovascular optical coherence tomography imaging and histological analysis[J].Neurosurgery,2011,69:430-439.
[15]Ughi GJ,Marosfoi MG,King RM,et al.A neurovascular high-frequency optical coherence tomography system enables in situ cerebrovascular volumetric microscopy[J].Nat Commun,2020,11:3851.
[16]Kasner SE,Chimowitz MI,Lynn MJ,et al.Predictors of ischemic stroke in the territory of a symptomatic intracranial arterial stenosis[J].Circulation,2006,113:555-563.
[17]Feng Y,Wu T,Wang T,et al.Correlation between intracranial vertebral artery stenosis diameter measured by digital subtraction angiography and cross-sectional area measured by optical coherence tomography[J].J Neurointerv Surg,2021,13:1002-1006.
[18]Xu X,Li M,Liu R,et al.Optical coherence tomography evaluation of vertebrobasilar artery stenosis:case series and literature review[J].J Neurointerv Surg,2020,12:809-813.
[19]孙瑄,杨明,余泽权,等.症状性颅内动脉粥样硬化性狭窄血管内治疗中国专家共识2022[J].中国卒中杂志,2022,17:863-888.
[20]Saba L,Saam T,Jager H,et al.Imaging biomarkers of vulnerable carotid plaques for stroke risk prediction and their potential clinical implications[J].Lancet Neurol,2019,18:559-572.
[21]Liem MI,Kennedy F,Bonati LH,et al.Investigations of carotid stenosis to identify vulnerable atherosclerotic plaque and determine individual stroke risk[J].Circ J,2017,81:1246-1253.
[22]Aboyans V,Ricco JB,Bartelink MEL,et al.2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases,in collaboration with the European Society for Vascular Surgery (ESVS):Document covering atherosclerotic disease of extracranial carotid and vertebral,mesenteric,renal,upper and lower extremity arteriesEndorsed by:the European Stroke Organization (ESO)The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS)[J].Eur Heart J,2018,39:763-816.
[23]Shibutani H,Fujii K,Shirakawa M,et al.Diagnostic accuracy of optical frequency domain imaging for identifying necrotic cores with intraplaque hemorrhage in advanced human carotid plaques[J].Am J Cardiol,2021,156:123-128.
[24]Scalone G,Niccoli G,Refaat H,et al.Not all plaque ruptures are born equal:an optical coherence tomography study[J].Eur Heart J Cardiovasc Imaging,2017,18:1271-1277.
[25]Tearney GJ,Yabushita H,Houser SL,et al.Quantification of macrophage content in atherosclerotic plaques by optical coherence tomography[J].Circulation,2003,107:113-119.
[26]Miura M,Yoshimura S,Yamada K,et al.Presence of plaque neovascularization on optical frequency domain imaging predicts progression of carotid artery stenosis[J].World Neurosurg,2019,127:e330-e336.
[27]Liu Y,Wang M,Zhang B,et al.Size of carotid artery intraplaque hemorrhage and acute ischemic stroke:a cardiovascular magnetic resonance Chinese atherosclerosis risk evaluation study[J].J Cardiovasc Magn Reson,2019,21:36.
[28]Bos D,Arshi B,van den Bouwhuijsen QJA,et al.Atherosclerotic carotid plaque composition and incident stroke and coronary events[J].J Am Coll Cardiol,2021,77:1426-1435.
[29]de Havenon A,Mossa-Basha M,Shah L,et al.High-resolution vessel wall MRI for the evaluation of intracranial atherosclerotic disease[J].Neuroradiology,2017,59:1193-1202.
[30]He Z,Luo J,Lv M,et al.Characteristics and evaluation of atherosclerotic plaques:an overview of state-of-the-art techniques[J].Front Neurol,2023:1159288.
[31]Lan L,Liu H,Ip V,et al.Regional high wall shear stress associated with stenosis regression in symptomatic intracranial atherosclerotic disease[J].Stroke,2020,51:3064-3073.
[32]Leng X,Lan L,Ip HL,et al.Hemodynamics and stroke risk in intracranial atherosclerotic disease[J].Ann Neurol,2019,85:752-764.
[33]Feng X,Fang H,Ip BYM,et al.Cerebral hemodynamics underlying Artery-to-Artery embolism in symptomatic intracranial atherosclerotic disease[J].Transl Stroke Res,2023,Online ahead of print.
[34]Okamoto N,Vengrenyuk Y,Fuster V,et al.Relationship between high shear stress and OCT-verified thin-cap fibroatheroma in patients with coronary artery disease[J].PLoS One,2020,15:e0244015.
[35]Kennedy MW,Fabris E,Ijsselmuiden AJ,et al.Combined optical coherence tomography morphologic and fractional flow reserve hemodynamic assessment of non-culprit lesions to better predict adverse event outcomes in diabetes mellitus patients:COMBINE (OCT-FFR) prospective study.Rationale and design[J].Cardiovasc Diabetol,2016,15:144.
[36]Kedhi E,Berta B,Roleder T,et al.Thin-cap fibroatheroma predicts clinical events in diabetic patients with normal fractional flow reserve:the COMBINE OCT-FFR trial[J].Eur Heart J,2021,42:4671-4679.
[37]Hartman EMJ,De Nisco G,Kok AM,et al.Wall shear stress-related plaque growth of lipid-rich plaques in human coronary arteries:an near-infrared spectroscopy and optical coherence tomography study[J].Cardiovasc Res,2023,119:1021-1029.
[38]Chen Z,Qin H,Liu J,et al.Characteristics of wall shear stress and pressure of intracranial atherosclerosis analyzed by a computational fluid dynamics model:a pilot study[J].Front Neurol,2019,10:1372.
[39]何钰,王建波,王武.颅内动脉粥样硬化性狭窄支架植入术后再狭窄机制及治疗新进展[J].介入放射学杂志,2021,30:1184-1189.
[40]Liu W,Huang J,He S,et al.Senescent endothelial cells′ response to the degradation of bioresorbable scaffold induces intimal dysfunction accelerating in-stent restenosis[J].Acta Biomater,2023,166:266-277.
[41]Song X,Qiu H,Wang S,et al.Hemodynamic and geometric risk factors for in-stent restenosis in patients with intracranial atherosclerotic stenosis[J].Oxid Med Cell Longev,2022,2022:6951302.
[42]刘锐,胡伟,孙文,等.中国光学相干断层成像技术在缺血性脑血管病介入诊疗中的应用专家建议[J].中国脑血管病杂志,2022,19:65-72.

备注/Memo

备注/Memo:
(收稿日期:2024-01-16)
(本文编辑:茹实)
更新日期/Last Update: 2025-01-22