颅内动脉粥样硬化性狭窄的血流分数评价  

Evaluation of fractional flow in patients with intracranial atherosclerotic stenosis

作　　者：陈谦[1] 郭再玉[1] Chen Qian;Guo Zaiyu(Department of Neurosurgery,Tianjin TEDA Hospital,Tianjin 300457,China)

机构地区：[1]天津市泰达医院神经外科,300457

出　　处：《国际脑血管病杂志》2019年第9期700-705,共6页International Journal of Cerebrovascular Diseases

基　　金：天津市滨海新区卫生计生系统引进应用新技术填补区空白项目(2018050);天津市滨海新区卫生局联合攻关项目(2012BWKL006)。

摘　　要：传统上脑血管狭窄的判定依赖于形态学狭窄程度测量结果,而缺乏血流动力学方面的理解和评估。目前,形态学狭窄程度仍是决定介入治疗的临床指征。无创性脑功能性评估无法准确定位狭窄病变部位对应的特定缺血区域,对血管病变的空间分辨率差,无法在手术中实时辅助介入治疗决策。冠状动脉狭窄的血流储备分数(fractional flow reserve,FFR)理论和压力导丝技术应用于冠状动脉功能性评价并指导介入治疗实践已有多年历史。随着对颅内血管形态学狭窄和血流动力学功能性障碍高危患者的筛选需要,血流分数评价在脑血管狭窄介入治疗中的作用日益显著。压力导丝在颅内动脉应用的安全性和可行性已得到一些研究的证实。血流分数评价在急性和慢性缺血性脑血管病中均有着广阔的应用前景。文章对血流分数评价在颅内动脉粥样硬化性狭窄患者中的应用进行了综述。Traditionally,the determination of cerebral vascular stenosis depends on the measurement of the degree of morphological stenosis,but it lacks the understanding and evaluation of hemodynamics.At present,the degree of morphological stenosis is still a clinical indication for interventional therapy.Non-invasive brain functional assessment cannot accurately locate the specific ischemic area corresponding to the stenotic lesion.Its spatial resolution to vascular lesions is poor,and it is not possible to assist decisions in real time during interventional therapy.The theory of fractional flow reserve(FFR)of coronary stenosis and pressure guidewire technology has been applied to the evaluation of coronary function and to guide the practice of interventional therapy for many years.With the need for screening for high-risk patients with intracranial vascular stenosis and hemodynamic dysfunction,the evaluation of fractional flow in the interventional treatment of cerebral vascular stenosis is increasingly significant.The safety and feasibility of the use of pressure guidewires in intracranial arteries have been confirmed by some studies.Evaluation of fractional flow has broad application prospects in both acute and chronic ischemic cerebrovascular diseases.This article reviews the application of fractional flow evaluation in patients with intracranial atherosclerotic stenosis.

关 键 词：颅内动脉硬化 血流动力学 脑血管循环 脑血管造影术 

分 类 号：R54[医药卫生—心血管疾病]