Cortical Cerebral Microinfarcts on 3T Magnetic Resonance Imaging in Patients With Carotid Artery Stenosis
Cortical Cerebral Microinfarcts on 3T Magnetic Resonance Imaging in Patients With Carotid Artery Stenosis
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DOI：
10.1161/strokeaha.118.023781
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发表时间：
2019-03-01
期刊：
影响因子：
8.3
通讯作者：
Mochizuki, Hideki
中科院分区：
文献类型：
--
作者：
Takasugi, Junji;Miwa, Kaori;Mochizuki, Hideki
背景和目的-颈动脉狭窄在老年人中很常见，并导致认知障碍和痴呆。皮质脑微梗死在血管性认知功能障碍和痴呆中起重要作用。我们的目的是研究颈动脉狭窄患者3 T磁共振成像上的CMI与临床和放射学特征（包括斑块形态）和认知功能之间的相关性。方法：89例超声显示颈动脉狭窄>30%的患者前瞻性入选，并接受脑和颈动脉磁共振成像。根据基于3D双反转恢复和液体衰减反转恢复图像的预定标准对CMI进行评级。结果：26例患者（29%;中位数0，范围0-9）发现CMI。经年龄和性别校正的Poisson回归模型显示，CMI与斑块内出血（率比，1.95; 95%CI，1.26-3.18）、腔隙性梗死（率比，1.54; 95%CI，1.00-2.44）和皮质梗死（率比，3.22; 95%CI，2.20-5.00）相关。在无症状患者（n=64）中也观察到这些相关性。在81例单侧颈动脉狭窄患者中，颈动脉狭窄同侧半球的CMI患病率和数量显著高于对侧半球（P=0.005和P
Background and Purpose- Carotid artery stenosis is common in the elderly and contributes to cognitive impairment and dementia. Cortical cerebral microinfarcts (CMIs) play an important role in vascular cognitive impairment and dementia. We aimed to investigate the association between CMIs on 3T magnetic resonance imaging and clinical and radiological features, including plaque morphology, and cognitive function in patients with carotid stenosis. Methods- Eighty-nine patients with >30% carotid stenosis on ultrasound were prospectively enrolled, and underwent brain and carotid artery magnetic resonance imaging. CMIs were rated according to predetermined criteria based on 3D-double inversion recovery and fluid-attenuated inversion recovery images. Results- CMIs were identified in 26 patients (29%; median number 0, range 0-9). Poisson regression models adjusted for age and sex revealed that CMIs were associated with intraplaque hemorrhage (rate ratio, 1.95; 95% CI, 1.26-3.18), lacunar infarcts (rate ratio, 1.54; 95% CI, 1.00-2.44), and cortical infarcts (rate ratio, 3.22; 95% CI, 2.20-5.00). These associations were also observed in asymptomatic patients (n=64). Of 81 patients with unilateral carotid stenosis, the prevalence and number of CMIs were significantly higher in the hemisphere ipsilateral to the carotid stenosis than in the contralateral hemisphere (P=0.005 and P