脑淀粉样血管病的MRI评价  

Magnetic resonance imaging evaluation of cerebral amyloid angiopathy

作　　者：杨君[1] 吴昭英[1] 张丽丽[1] 王玉忠[1] 冯勋刚[1] Yang Jun;Wu Zhaoying;Zhang Lili;Wang Yuzhong;Feng Xungang(Department of Neurology,the Affiliated Hospital of Jining MedicalUniversity,Jining 272029,China)

机构地区：[1]济宁医学院附属医院神经内科,济宁272029

出　　处：《国际脑血管病杂志》2023年第5期378-383,共6页International Journal of Cerebrovascular Diseases

摘　　要：脑淀粉样血管病(cerebral amyloid angiopathy,CAA)是一种常见的脑小血管病,主要是由于β-淀粉样蛋白沉积于直径<200μm的皮质及软脑膜小血管所致,是老年人自发性脑出血(尤其是脑叶出血)的主要原因。早期症状隐匿,随着疾病的进展可表现为脑出血、认知功能减退、短暂性局灶性神经系统症状发作、脑梗死、癫痫、头痛等。MRI显示,CAA是一种出血与缺血共存的疾病。CAA的MRI表现包括脑出血、脑微出血、脑凸面蛛网膜下腔出血及皮质表面铁沉积、脑微梗死、CAA相关炎症、白质高信号、血管周围间隙扩大、脑萎缩以及腔隙等。文章对散发性CAA的MRI表现进行了综述。Cerebral amyloid angiopathy(CAA)is a common cerebral small vessel disease,mainly caused byβ-amyloid deposition on the small vessels less than 200μm in diameter in cortex and leptomeninges.CAA is a major cause of spontaneous intracerebral hemorrhage in the elderly,especially lobar location.Early symptoms are insidious,and as the disease progress,they manifest as cerebral hemorrhage,cognitive decline,transient focal neurological episodes,cerebral infarction,epilepsy,headache,etc.MRI revealed that CAA is a disease in which bleeding and ischemia coexist,and even inflammation and immune responses are involved.MRI findings of CAA include cerebral hemorrhage,cerebral microbleeds,convexity subarachnoid hemorrhage and cortical superficial siderosis,cortical microinfarcts,CAA-associated inflammation,white matter hyperintensities,enlarged perivascular spaces,cerebral atrophy and lacune,etc.The same patient often has several of the above manifestations,and each manifestation has different specificity for the diagnosis of CAA.The rapid development of MRI technology has led to the improvement of the diagnostic level of CAA,and it is of great clinical significance to understand these imaging findings.This article reviews the MRI findings of sporadic CAA.

关 键 词：脑淀粉样血管病 磁共振成像 诊断 鉴别 

分 类 号：R743[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]