INCIDENTAL SUBCORTICAL LESIONS IDENTIFIED ON MAGNETIC-RESONANCE-IMAGING IN THE ELDERLY .2. POSTMORTEM PATHOLOGICAL CORRELATIONS
INCIDENTAL SUBCORTICAL LESIONS IDENTIFIED ON MAGNETIC-RESONANCE-IMAGING IN THE ELDERLY .2. POSTMORTEM PATHOLOGICAL CORRELATIONS
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DOI：
10.1161/01.str.17.6.1090
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发表时间：
1986-11-01
期刊：
影响因子：
8.3
通讯作者：
HODAK, JA
中科院分区：
文献类型：
--
作者：
AWAD, IA;JOHNSON, PC;HODAK, JA
老年人磁共振成像 (MRI) 发现的皮层下病变的病理相关性尚不清楚。对连续 7 名因非神经原因死亡的老年患者的大脑进行了尸检体外质子 MRI。将样本分别浸入盐水和甲醛中，在新鲜和固定状态下进行扫描。 1.5 特斯拉超导系统与多重自旋回波协议一起使用，生成 T2 加权图像。皮层下 MRI 病变定位于三个维度，并在脑切割时识别。此外，还从第八名患者死亡前 11 天接受 MRI 的情况中获得了病理相关性。组织学检查以盲法进行，包括来自同一大脑的对照区域。皮层下 MRI 病变被发现与动脉硬化、血管周围间隙扩张和血管扩张相关（p < 0.05）。这些组织学变化是“etat cible”的特征，与皮质下 MRI 病变一样，与年龄和高血压有关。扩张的血管周围的脑实质收缩（或萎缩）会导致充满细胞外水的广泛的隧道网络。来自大脑这些区域的质子 MRI 信号将会增加。神经胶质增生和小面积梗塞偶尔与“etat cible”共存，但这些并不存在于所有具有 MRI 病变的区域，并且不能仅通过 MRI 信号来区分。总之，临床和病理相关性支持了一个统一的假设，即 MRI 提供了由衰老和慢性脑血管疾病引起的脑实质改变的非特异性指标。
The pathological correlates of subcortical lesions noted on magnetic resonance imaging (MRI) in the elderly are not known. Postmortem in vitro proton MRI was performed on the brains of seven consecutive elderly patients dying of nonneurological causes. Scans were done in the fresh and fixed states with the specimen immersed in saline and formaldehyde respectively. A 1.5 Tesla superconductive system was used with a multiple spin-echo protocol generating T2 weighted images. Subcortical MRI lesions were localized in three dimensions and identified at brain cutting. In addition, pathological correlations were obtained from an eighth patient who underwent MRI eleven days before death. Histological examinations were performed in a blinded fashion, including control areas from the same brains. Subcortical MRI lesions were found to be associated with arteriosclerosis, dilated perivascular spaces, and vascular ectasia (p < 0.05). These histological changes were characteristic of "etat crible" which, like subcortical MRI lesions, is associated with age and hypertension. Shrinkage (or atropy) of the brain parenchyma around ectatic blood vessels would result in an extensive network of tunnels filled with extracellular water. The proton MRI signal from such areas of the brain would be increased. Gliosis and small areas of infarction occasionally coexisted with "etat crible", but these were not present in all areas with MRI lesions and could not be distinguished by MRI signal alone. In conclusion, clinical and pathological correlations lend support to the uniform hypothesis that MRI provides a nonspecific index of brain parenchymal alterations caused by aging and chronic cerebrovascular disease.