MRT bei zerebralen Mikroangiopathien

Zusammenfassung

Unter einer zerebralen Mikroangiopathie (ZMA) versteht man Erkrankungen der kleinen hirnversorgenden Gefäße, die für ca. 20 bis 30% aller ischämischen Schlaganfälle verantwortlich sind. Während einige ZMA ausschließlich die zerebralen Gefäße betreffen, handelt es sich bei anderen Erkrankungen um Systemerkrankungen, die zu extrakraniellen Manifestationen führen können. Eine einheitliche Klassifikation der ZMA existiert in der Literatur nicht. Sinnvoll ist die Unterscheidung zwischen den häufigen erworbenen und den überwiegend sehr seltenen, angeborenen ZMA. In dieser Arbeit werden charakteristische MRT-Befunde, die bei allen Formen der ZMA in mehr oder weniger starker Ausprägung und Lokalisation gefunden werden, dargestellt. Im Anschluss werden spezifische bildgebende Charakteristika der wichtigsten Formen der ZMA, das heißt, der degenerativen Mikroangiopathie (DMA), der zerebralen Amyloidangiopathie (CAA), der CADASIL-Erkrankung, des Morbus Fabry, der hereditären Amyloidangiopathien und der COL4A1-assoziierten, zerebrale Mikroangiopathien, erläutert.

Summary

Cerebral small vessel diseases (CSVD) constitute a rather heterogenous group of diseases characterized by pathological changes of the small cerebral vessels. They account for 20 to 30% of all ischemic strokes. While some CSVD are restricted to the cerebral vessels, others represent systemic diseases and also lead to extracranial manifestations. No widely accepted classification of these diseases exists, to date. However, it is reasonable to distinguish the very common sporadic CVSD from a variety of rare, hereditary forms. The first part of this review focuses on general MR imaging findings in CSVD. Characteristic imaging signs of the specific disease entities, i. e. degenerative microangiopathy, sporadic cerebral amyloid angiography, CADASIL, Fabry’s disease, hereditary cerebral amyloid angiopathies, and COL4A1-related cerebral small vessel diseases are detailed in the second part of the review.

Schlüsselwörter

Zerebrale Mikroangiopathien - MRT - Bildgebung - zerebrale Amyloidangiopathie

Keywords

Cerebral microangiopathies - MRI - imaging - cerebral amyloid angiopathy

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