CNS Involvement in Primary Sjogren Syndrome: Assessment of Gray and White Matter Changes With MRI and Voxel-Based Morphometry
CNS Involvement in Primary Sjogren Syndrome: Assessment of Gray and White Matter Changes With MRI and Voxel-Based Morphometry
复制标题
DOI：
10.2214/ajr.10.5984
复制
发表时间：
2011-11-01
影响因子：
5
通讯作者：
Argyropoulou, Maria I.
中科院分区：
文献类型：
--
作者：
Tzarouchi, Loukia C.;Tsifetaki, Niki;Argyropoulou, Maria I.
目标。本研究的目的是用MRI评价原发性干燥综合征患者脑灰质和白质结构的受累情况。对53例原发性干燥综合征患者、18例年龄和病程相匹配的系统性硬化症患者和35例年龄匹配的对照组受试者进行了FLAIR磁共振成像检测脑白质高信号(WMHIs)。结果：53例原发性干燥综合征患者中有38例，18例系统性硬化症患者中有6例，35例对照中有17例观察到WMHI。原发性干燥综合征患者WMHI2 mm以上和<2 mm的个数均高于对照组(P=0.004；<2 mm，P=0.001)。在原发性干燥综合征患者和系统性硬化症患者中，WMHI的数量没有显著差异。在控制了年龄因素后，原发性干燥综合征患者的病程与WMHI值呈正相关(p=0.037)，与WMHI值大于等于2 mm的WMHI值呈正相关(p=0.023)。与对照组相比，原发性干燥综合征患者大脑皮质、深部灰质和小脑的灰质体积减少。与灰质萎缩相对应的脑白质体积的丢失与其对应的穹隆体区白质体积的减少有关(p<；0.05)。结论：原发性干燥综合征患者存在WMHIS和灰白质萎缩，可能与脑血管炎有关。
OBJECTIVE. The purpose of this study was to evaluate with MRI the involvement of gray matter and white matter structures in patients with primary Sjogren syndrome.SUBJECTS AND METHODS. Fifty-three patients with primary Sjogren syndrome, 18 age-and disease duration-matched patients with systemic sclerosis, and 35 age-matched control subjects were examined for differences in white matter hyperintensities (WMHIs) detected on FLAIR MR images. Differences in brain volume between patients with primary Sjogren syndrome and controls were studied by application of voxel-based morphometry to a 3D T1-weighted sequence.RESULTS. WMHIs were observed in 38 of the 53 patients with primary Sjogren syndrome, six of 18 patients with systemic sclerosis, and 17 of 35 controls. The numbers of WMHIs 2 mm or larger and the number smaller than 2 mm were higher in patients with primary Sjogren syndrome than in controls (>= 2 mm, p = 0.004; < 2 mm, p < 0.001). No significant difference was observed in the number of WMHIs in primary Sjogren syndrome patients and that in systemic sclerosis patients. After control for age, a positive relation was found between disease duration and total number of WMHIs (p = 0.037) and number of WMHIs 2 mm or larger (p = 0.023) in patients with primary Sjogren syndrome. In comparison with the controls, patients with primary Sjogren syndrome had decreased gray matter volume in the cortex, deep gray matter, and cerebellum. Associated loss of white matter volume was observed in areas corresponding to gray matter atrophy and in the corpus callosum (p < 0.05).CONCLUSION. Patients with primary Sjogren syndrome have WMHIs and gray and white matter atrophy, probably related to cerebral vasculitis.