International Circulation: In the presence of intracranial arterial stenosis， is there an indicator for evaluating arterial sclerosis?

　　David Wang: Is there a way? Currently we use MRI to obtain the magnetic resonance and imaging， angiography， and CT angiography to evaluate the disease. We now have a computer simulation by extracting the data you have from CTA or MRI to look at the hemodynamics for example that every heartbeat can generate a different pressure. Certain endothelium should be looked at. With every beat that we can see where the vulnerable area is and if it is at risk to rupture or can cause a thrombus， which causes a stroke.

　　《国际循环》：存在颅内动脉狭窄时，我们应如何评估动脉粥样硬化？

　　David Wang教授：有这样的方法吗？目前我们可通过MRI、血管造影及CT血管造影对疾病进行评估。我们现在已经有了基于CTA或MRI数据的计算机模拟系统来评估患者的血液动力学情况，以确定每次心跳是否能产生不同的压力、观察内皮系统情况、确定薄弱区域位置并评估其是否存在破裂风险、是否会导致血栓形成，从而导致卒中。

　　International Circulation: My last question here， what are the risk factors for intracranial arterial stenosis? How should those be managed?

　　David Wang: The risks for intracranial atherosclerotic disease is not much different than the other systemic diseases for example as commonly known as the 3 Highs: high cholesterol， high blood pressure， and high glucose. Those are the 3. This is known and risk factors for developing disease and other atherosclerotic disease， and I think in addition to that I think smoking plays a bigger role. We have also known that maybe when people have lower HDL， high density lipoprotein， when we check the cholesterol we check the low LDL which is sometimes known as bad cholesterol， but the HDL is the good cholesterol. People with a lower HDL may be at risk at developing intracranial sclerotic disease， so maybe that is another risk factor to recommend we talk about. Other than that， homocysteine levels may play a role but that still need to be studied. That is pretty much it.

　　《国际循环》：最后一个问题是，颅内动脉狭窄的危险因素有哪些？如何对其进行管理？

　　David Wang教授：与其他全身疾病相比，颅内动脉粥样硬化性疾病的危险因素并没有太大差异。常见的“三高“高血脂、高血压及高血糖是颅内动脉粥样硬化性疾病及其他动脉粥样硬化性疾病的已知主要危险因素。除此之外，吸烟也在颅内动脉粥样硬化性疾病的发生发展过程中发挥了重要作用。就血脂而言，我们都知道LDL-C是“坏”血脂，而HDL-C是“好”血脂。HDL-C水平较低可增加颅内动脉粥样硬化性疾病发生风险，因此是我们要讨论的颅内动脉粥样硬化性疾病的另一个危险因素。此外，同型半胱氨酸水平也可能与颅内动脉粥样硬化性疾病具有相关性，但仍需要进一步研究。