范章燕 任力杰 蔡婧婧

[摘要] 各种颅内动脉疾病病因复杂，发病率高，特别是狭窄性颅内动脉疾病，在高分辨磁共振应用前，临床上常难以进行鉴别。高分辨磁共振是唯一可以在活体内观察颅内动脉管壁的检查，且其是可重复性、高场强、无辐射的无创性检查。不同狭窄性的颅内动脉疾病具有不同的管壁特征，高分辨磁共振在鉴别各种颅内动脉狭窄性疾病起着重要作用。随着高分辨磁共振的发展，可以逐渐实现精准的影像学诊断。本文对各种狭窄性颅内动脉疾病的高分辨磁共振研究进展做一综述。

[关键词] 高分辨磁共振成像；颅内动脉；动脉硬化；夹层

[中图分类号] R445.2 [文献标识码] A [文章编号] 1673-9701（2018）21-0165-04

[Abstract] The causes of various intracranial arterial diseases are complicated and the incidence is high， especially stenotic intracranial arterial disease. Before high-resolution magnetic resonance imaging， it is often difficult to distinguish clinically. High-resolution magnetic resonance is the only test that can observe intracranial arterial wall in vivo， and it is a non-invasive examination with repeatability， high field strength， and no radiation. Different stenotic intracranial arterial diseases have different characteristics of the vessel wall. High-resolution magnetic resonance imaging plays an important role in identifying various intracranial arterial stenosis diseases. With the development of high-resolution magnetic resonance， accurate imaging diagnosis can be gradually achieved. This article reviews the advances in high-resolution magnetic resonance imaging of various stenotic intracranial arterial diseases.

[Key words] High resolution magnetic resonance imaging； Intracranial arteries； Atherosclerosis； Dissection

颅内动脉疾病的疾病纷繁复杂，最常见为颅内动脉粥样硬化，其次为烟雾病，还可见于颅内动脉夹层、血管炎等。目前，临床上常用的评估颅内动脉的影像方法有CT血管成像、数字减影血管造影、磁共振血管成像、经颅多普勒等，存在一定局限性，无法准确判断血管壁结构、分析血管狭窄原因。早期诊断颅内动脉疾病，可以避免延误治疗。高分辨磁共振成像（High-Resolution MRI，HRMRI）具有高场强、无辐射的无创性检查，目前已用于诊断各种颅内动脉疾病。

1 HRMRI血管壁成像技术

随着磁共振成像技术的发展，HRMRI的图像质量不断提高。研究表明，使用32通道头颈联合线圈，可以达到高信噪比，覆盖范围大，同时进行颅内和颅外动脉斑块的高分辨率成像[1]。HRMRI血管壁成像主要采用黑血技术。通过运动增敏预脉冲和双反转恢复来产生足够的图像对比[2]。……