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首页> 外文期刊>Journal of Cerebral Blood Flow and Metabolism: Official Journal of the International Society of Cerebral Blood Flow and Metabolism >Magnetic resonance imaging for assessment of cerebrovascular reactivity in cerebral small vessel disease: A systematic review
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Magnetic resonance imaging for assessment of cerebrovascular reactivity in cerebral small vessel disease: A systematic review

机译:磁共振成像评估脑小血管疾病中脑血管反应性的系统评价

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摘要

Cerebral small vessel disease (SVD) pathophysiology is poorly understood. Cerebrovascular reactivity (CVR) impairment may play a role, but evidence to date is mainly indirect. Magnetic resonance imaging (MRI) allows investigation of CVR directly in the tissues affected by SVD. We systematically reviewed the use of MRI to measure CVR in subjects with SVD. Five studies (total n = 155 SVD subjects, 84 controls) provided relevant data. The studies included different types of patients. Each study used blood oxygen level dependent (BOLD) MRI to assess CVR but a different vasoactive stimulus and method of calculating CVR. CVR decreased with increasing white matter hyperintensities in two studies (n = 17, 11%) and in the presence of microbleeds in another. Three studies (n = 138, 89%) found no association of CVR with white matter hyperintensities. No studies provided tissue-specific CVR values. CVR decreased with age in three studies, and with female gender and increasing diastolic blood pressure in one study. Safety and tolerability data were limited. Larger studies using CVR appear to be feasible and are needed, preferably with more standardized methods, to determine if specific clinical or radiological features of SVD are more or less associated with impaired CVR.
机译:对脑小血管疾病(SVD)的病理生理了解甚少。脑血管反应性(CVR)损伤可能起一定作用,但迄今为止的证据主要是间接的。磁共振成像(MRI)可以直接在受SVD影响的组织中研究CVR。我们系统地回顾了使用MRI来测量SVD患者的CVR。五项研究(总共n = 155个SVD受试者,84个对照)提供了相关数据。研究包括不同类型的患者。每项研究均使用血氧水平依赖性(BOLD)MRI评估CVR,但采用不同的血管活性刺激和计算CVR的方法。在两项研究中,CVR随着白质过高症的增加而降低(n = 17、11%),而在另一项研究中则存在微出血。三项研究(n = 138,89%)未发现CVR与白质高信号相关。没有研究提供组织特异性CVR值。在三项研究中,CVR随着年龄的增长而下降,在一项研究中,女性随着舒张压的升高而下降。安全性和耐受性数据有限。使用CVR进行更大的研究似乎是可行的,并且需要,最好是采用更标准化的方法,以确定SVD的特定临床或放射学特征或多或少与CVR受损有关。

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