Neuroradiologische Diagnostik und interventionelle Therapie zerebrovaskulärer Erkrankungen

Zusammenfassung

Die Neuroradiologie hat sich in Diagnostik und interventioneller Therapie zerebrovaskulärer Erkrankungen im letzten Jahrzehnt rasant weiterentwickelt. Durch multimodale Bildgebungsverfahren ist bei akuten zerebralen Ischämien eine Abschätzung des potenziell zu rettenden Hirngewebes in der Akutphase möglich und kann so die Therapieentscheidung leiten. Die neue Flachdetektorgeneration der Angiografiesysteme ermöglicht die schnelle Akquisition von Volumendaten und entsprechende Sekundärrekonstruktionen, wovon insbesondere die neurointerventionellen Verfahren profitieren. In der Behandlung der akuten zerebralen Ischämie kommen bei proximalen Hirnarterienverschlüssen zunehmend mechanische intraarterielle Verfahren zum Einsatz. Die endovaskuläre Behandlung von symptomatischen Stenosen der hirnversorgenden Arterien mithilfe von Stents ist ein etabliertes Verfahren. Für die Behandlung von zerebralen Aneurysmen ist die endovaskuläre Coilembolisation die Methode der ersten Wahl. Durch diese Entwicklung nimmt die Neuroradiologie nicht nur in der Diagnostik, sondern auch in der Therapie von zerebrovaskulären Erkrankungen einen immer wichtigeren Stellenwert ein.

Summary

Diagnostic and interventional neuroradiology became increasingly important in the field of cerebrovascular disease within the last decade. Multimodal imaging can estimate the amount of tissue at risk in the acute stage of ischemia and thus, guide therapeutic decision. The new generation of flat panel angiography systems enables the rapid acquisition of volume data and secondary reconstruction resulting in increased benefit for various neurointerventional procedures. Intraarterial mechanical devices for the treatment of proximal cerebral artery occlusion in acute cerebral ischemia are increasingly used. The endovascular treatment of symptomatic cervical or cerebral artery stenosis with stent is an accepted method. For the treatment of cerebral aneurysms, endovascular coilembolization is today the method of choice. With all of this improvement, neuroradiology emerged as key role in the acute diagnosis and therapy of cerebrovascular disease.

Schlüsselwörter

Neuroradiologie - zerebrovaskuläre Erkrankungen - Bildgebung - interventionelle Therapie

Keywords

Neuroradiology - cerebrovascular disease - imaging - interventional therapy

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