Comparison of the pathology of cerebral white matter with post-mortem magnetic resonance imaging (MRI) in the elderly brain
Comparison of the pathology of cerebral white matter with post-mortem magnetic resonance imaging (MRI) in the elderly brain
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DOI：
10.1111/j.1365-2990.2004.00550.x
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发表时间：
2004-08-01
影响因子：
5
通讯作者：
Ince, PG
中科院分区：
文献类型：
--
作者：
Fernando, MS;O'Brien, JT;Ince, PG
磁共振成像 (MRI) 脑部扫描显示的白质病变 (WML) 与衰老有关。它们与特定疾病无关，并且它们对认知和其他大脑功能的影响尚不清楚。病理学研究经常忽略 WML 的系统调查，因为需要研究多个完整的冠状组织块，并且脑室周围和深层皮质下区域中识别的病变的重要性不确定。尸检 MRI 提供了一种绘制 WML 的方法，但该方法的敏感性和特异性尚未解决。在这项研究中，将固定脑切片中 WML 的死后 MRI 与捐赠给医学研究委员会认知功能和衰老研究 (MRC CFAS) 的 33 个大脑的病理学进行了比较。这项研究表明，MRI 检测 WML 的敏感性低于病理学：脑室周围病变 (PVL) 敏感性 = 95% (87-99%)，特异性 = 71% (44-90%)；深部皮质下病变 (DSCL) 敏感性 = 86% (79-93%)，特异性 = 80% (72-88%)。假阴性 MRI 与较轻的病理学相关，但仅通过髓磷脂衰减检测到的病变显示小胶质细胞和内皮细胞激活。因此，福尔马林固定脑切片的死后 MRI 是获得有关脑白质疾病严重程度和分布的系统数据的可靠方法，并且似乎可以检测那些最有可能产生临床影响的 WML。
White matter lesions (WML) on magnetic resonance imaging (MRI) brain scans are associated with ageing. They are unrelated to specific disorders, and their impact on cognitive and other brain functions is poorly characterized. Pathological studies often omit systematic survey of WML because of the need to study multiple full coronal tissue blocks, and uncertainty over the significance of lesions identified in periventricular and deep subcortical regions. Post-mortem MRI provides a means of mapping WML but the sensitivity and specificity of the method are unresolved. In this study post-mortem MRI of WML in fixed brain slices was compared with pathology in 33 brains donated to the Medical Research Council Cognitive Function and Ageing Study (MRC CFAS). This study shows that MRI detection of WML was less sensitive than pathology: periventricaular lesions (PVL) sensitivity = 95% (87-99%), specificity = 71% (44-90%); deep subcortical lesions (DSCL) sensitivity = 86% (79-93%), specificity = 80% (72-88%). False negative MRI was associated with milder pathology, but lesions detected by myelin attenuation alone showed both microglial and endothelial activation. Therefore post-mortem MRI of formalin-fixed brain slices is a reliable method to obtain systematic data on the severity and distribution of cerebral white matter disease, and appears to detect those WML most likely to have clinical impact.