小脑梗死的影像评估及临床研究进展  

Imaging evaluation and clinical research progress of cerebellar infarction

作　　者：陈文静 沈龙山 朱越 CHEN Wenjing;SHEN Longshan;ZHU Yue(Department of Radiology,Bengbu Hospital of Shanghai General Hospital(Second Affiliated Hospital of Bengbu Medical University),Bengbu 233000,China;School of Medical Imaging,Bengbu Medical University,Bengbu 233000,China;Key Laboratory of Digital Medicine and Intelligent Health of Anhui Universities(Bengbu Medical University),Institute of Clinical Applied Anatomy,Bengbu Medical University,Bengbu 233000,China)

机构地区：[1]上海市第一人民医院蚌埠医院(蚌埠医科大学第二附属医院)放射科,安徽蚌埠233040 [2]蚌埠医科大学医学影像学院,安徽蚌埠233030 [3]数字医学与智慧健康安徽普通高校重点实验室(蚌埠医科大学),蚌埠医科大学临床应用解剖研究所,安徽蚌埠233004

出　　处：《分子影像学杂志》2024年第7期769-773,共5页Journal of Molecular Imaging

基　　金：蚌埠医学院转化医学重点项目(BYTM2019045);数字医学与智慧健康安徽普通高校重点实验室(蚌埠医学院)一般项目(AHCM2022W001、AHCM2023W001)。

摘　　要：小脑梗死是缺血性脑卒中的重要类型之一,发病率并不高,仅占缺血性脑卒中的2%~3%,但具有死亡率高、致残率高的特点,一旦病情恶化进展迅速。由于小脑梗死的临床症状多样化且不典型,小脑梗死并未被充分认识,容易漏诊误诊。小脑梗死的病因机制复杂很难确定,传统影像技术常常受椎-基底动脉解剖变异的影响,难以区分解剖变异和疾病。为了进一步发现和诊断小脑梗死的病因,可以考虑增加基底平行解剖扫描MRI,基底平行解剖扫描MRI作为飞行时间磁共振血管造影的补充序列,可以提供准确的椎-基底动脉三维解剖视图,旨在区分动脉粥样硬化、夹层及发育不全。小脑梗死症状不典型、病因复杂及预后差,本文从临床表现、影像评估、临床诊断及治疗等几个方面对小脑梗死进行综述,更进一步全面了解小脑梗死,为临床预防及治疗提供参考。Cerebellar infarction,a significant subtype of ischemic stroke,is characterized by high mortality and disability rates,often leading to rapid disease progression.Despite its relatively low incidence(2%-3%of all ischemic strokes),cerebellar infarction frequently goes underrecognized due to diverse and atypical clinical symptoms,resulting in misdiagnosis or missed diagnosis.Determining the etiological mechanism underlying cerebellar infarction is complex and challenging.Traditional imaging techniques face difficulties in differentiating between normal anatomical variants and pathological conditions due to anatomical variations in the vertebral basilar artery.To enhance identification and diagnosis of cerebellar infarction etiology,incorporating basal-parallel anatomical scan as a complementary sequence alongside time-of-flight magnetic resonance angiography can provide an accurate three-dimensional view of vertebrobasilar artery anatomy,facilitating differentiation between atherosclerosis,dissection,and hypoplasia.Given the atypical symptoms,complex etiology,and poor prognosis associated with cerebellar infraction.This article comprehensively reviewed its clinical manifestations,imaging evaluation methods,clinical diagnosis approaches,and treatment strategies aiming to deepen our understanding of this condition while providing valuable insights for its prevention and management.

关 键 词：小脑梗死 小脑后下动脉 基底平行解剖扫描 枕下减压颅骨切除术 

分 类 号：R743.3[医药卫生—神经病学与精神病学]