Cerebrovascular disease encompasses a range of pathologies that affect different components of the cerebral vasculature and brain parenchyma. Large artery atherosclerosis, acute cerebral ischaemia, and intracerebral small vessel disease all demonstrate altered metabolic processes that are key to their pathogenesis. Although structural imaging techniques such as MRI are the mainstay of clinical care and research in cerebrovascular disease, they have limited ability to detect these pathophysiological processes in vivo. By contrast, PET can detect and quantify metabolic processes that are relevant to each facet of cerebrovascular disease. Information obtained from PET studies has helped to shape the understanding of key concepts in cerebrovascular medicine, including vulnerable atherosclerotic plaque, salvageable ischaemic penumbra, neuroinflammation and selective neuronal loss after ischaemic insult. PET has also helped to elucidate the relationships between chronic hypoxia, neuroinflammation, and amyloid-β deposition in cerebral small vessel disease. This Review describes how PET-based imaging of metabolic processes at the neurovascular interface has contributed to our understanding of cerebrovascular disease.

脑血管疾病包括一系列影响脑血管系统和脑实质不同成分的病理。大动脉粥样硬化、急性脑缺血和脑内小血管疾病都表现出改变的代谢过程，这是其发病机制的关键。尽管 MRI 等结构成像技术是脑血管疾病临床护理和研究的支柱，但它们在体内检测这些病理生理过程的能力有限. 相比之下，PET 可以检测和量化与脑血管疾病各个方面相关的代谢过程。从 PET 研究中获得的信息有助于形成对脑血管医学关键概念的理解，包括易损动脉粥样硬化斑块、可挽救的缺血半暗带、神经炎症和缺血性损伤后的选择性神经元丢失。PET 还有助于阐明脑小血管疾病中慢性缺氧、神经炎症和淀粉样蛋白-β 沉积之间的关系。本综述描述了基于 PET 的神经血管界面代谢过程成像如何有助于我们对脑血管疾病的理解。