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  

Advances in the application of optical coherence tomography in the diagnosis and treatment of intracranial atherosclerotic stenosis

作　　者：陆悦新 王明[2] 万曙[2] LU Yuerin;WANG Ming;WAN Shu(The Second Clinical Medical College,Zhejiang University of Traditional Chinese Medicine,Hangzhou,Zhejiang Province 310000,China)

机构地区：[1]浙江中医药大学第二临床医学院,浙江杭州310000 [2]浙江大学医学院附属浙江医院脑科中心

出　　处：《介入放射学杂志》2025年第1期103-108,共6页Journal of Interventional Radiology

基　　金：浙江省“高层次人才特殊支持计划”(2022R52038);浙江省重点研发项目(2021C03105)。

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。Intracranial atherosclerotic stenosis(ICAS)is the most prevalent etiology of ischemic stroke in the Asian population.Predicting the risk of stroke in patients with ICAS and stratifying the stroke risk can help clinicians to take early interventional measures so as to improve patient outcomes.Optical coherence tomography(OCT)is a novel ultrahigh-resolution endovascular real-time imaging technique.OCT has multiple advantages in the assessment of atherosclerotic plaque characteristics and lumen morphology,especially in the display of the fine structural features of vulnerable plaques,which provides strong image support for the assessment of the plaque stability.Combined with hemodynamic assessment,OCT can judge the formation and development trend of plaques and predict the risk of stroke recurrence in patients with ICAS,which is of great significance in guiding targeted individualized interventional therapy.This paper aims to make a comprehensive review about the recent progress in OCT technology and its integration with hemodynamic assessment for the diagnosis and treatment of ICAS,to discuss the potential application prospects of OCT in the field of cerebrovascular diseases,so as to provide a scientific basis for the risk assessment,disease monitoring,and decision-making of treatment for patients with ICAS.

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 

分 类 号：R540.4[医药卫生—心血管疾病]