摘要
目的明确脑淀粉样血管病(CAA)患者白质损害的影像学特征,以及与其他脑小血管病(CSVD)标志物的相关性。方法回顾性分析2014年12月至2016年12月收集的28例很可能的CAA患者(CAA组)和56例合并CSVD危险因素的健康老年人(非CAA组)在临床信息,影像学标志物和白质损害之间的差异;白质损害分别从脑网络连接改变和定量白质高信号(WMH)体积的严重程度和分布特征(后-前部梯度)进行评估,以弥散张量成像中各向异性分数(FA)作为测量脑网络连接参数。分析CAA患者白质损害与脑微出血灶(CMBs)、血管周间隙(PVS)、CSVD积分等影像标志物的相关性。结果白质损害方面,与非CAA组比较,CAA组的全脑WMH体积(P<0.001)和后-前部梯度(P=0.004)增加,FA后部均值(P=0.037)和后-前部梯度(P=0.004)降低。相关性分析表明:CAA组的全脑FA均值与WMH体积无相关性(P=0.151),而两组的后-前部梯度线性相关(P=0.029);全脑FA均值与脑叶CMBs数目(P=0.036)、CSVD积分(P=0.049)存在相关性,但这一相关性未在WMH体积中发现。结论脑网络连接下降、WMH体积增加是CAA白质损害的重要影像学标志物,具有后部分布为主的显著特征。脑网络连接下降可在一定程度上反映CAA的病理改变和疾病严重程度。
Aim To describe imaging features of white matter damage in cerebral amyloid angiopathy （CAA）, and determine its relcvancc with other ccrebral small vessel disease （CSVD） markers. Methods Differences of clinical data, imaging markers and white matter damage between 28 probnble CAA patients and 56 healthy eider subjects with risk factors for CSVD from December 2014 to December 2016 were retrospectively analyzed. istribution pattern （posterior-anterior gradient） in brain network connection changes and quantitative white matter hyperintensities （WMH） volumes. Fractional anisotropies （FA） in diffusion tensor imaging were calculated as the parameters for brain network connection. In CAA patients, the association between white matter damage and other imaging markers including cerebral microbleeds （CMBs）, perivascular space （PVS） and CSVD score was analyzed. Results For white matter damage, compared to healthy elder subjects, CAA patients demonstrated prominently increased WMH volumes （P〈0.001） and posterior-anterior gradient of WMH volume fraction （P=0.004）, but decreased posterior mean FA （P=0.037） and posterior-anterior gradient of FA （P=0.004）. In CAA patients, there was a linear correlation between gradient distribution of mean FA and WMH volumes （P=0.029）, but no association in the severity （P=0.151） of global mean FA and WMH volumes. Lobar CMBs number（P=0.036） and CSVD score （P=-0.049） were statistically correlated with mean FA of the whole brain but not with WMH volumes. Conclusion White matter damage indicated by decreased brain network connections and increased WMH volumes was an important imaging marker for CAA, which exhibited a predominant predisposition for posterior brain regions. The decline of brain network connections might potentially implicate pathological changes and disease severity in CAA patients.
出处
《中国临床神经科学》
2017年第5期505-511,共7页
Chinese Journal of Clinical Neurosciences
基金
上海市科委青年科技启明星计划(编号:15QA1400900)
中匈科学合作基金-青年学者计划(编号:HCSCF-2016-3)
关键词
脑淀粉样血管病
脑小血管病
白质损害
白质高信号
脑网络连接
cerebral amyloid angiopathy
cerebral small vessel disease
white matter damage
white matter hyperintensities
brain network connection
