Application of Texture Analysis to Study Small Vessel Disease and Blood-Brain Barrier Integrity.
Application of Texture Analysis to Study Small Vessel Disease and Blood-Brain Barrier Integrity.
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DOI：
10.3389/fneur.2017.00327
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发表时间：
2017
影响因子：
3.4
通讯作者：
Wardlaw JM
中科院分区：
文献类型：
--
作者：
Valdés Hernández MDC;González-Castro V;Chappell FM;Sakka E;Makin S;Armitage PA;Nailon WH;Wardlaw JM
我们评估了纹理分析用于评估血脑屏障（BBB）在小血管疾病（SVD）中的作用的替代使用。我们对204例脑卒中患者在静脉注射钆前后20分钟进行脑磁共振成像。我们对组织、白质高信号（WMH）进行了分割，并应用了有效的视觉评分。我们测量了对比前后所有组织的纹理特征，并使用ANCOVA评估SVD指标对对比前后变化的影响，使用Kruskal-Wallis评估患者组之间的显著性，使用Fazekas评分评估脑脊液（CSF）对比前后变化的线性混合模型。在SVD指标较高的正常组织中，纹理“均匀性”增加始终比异常组织更明显。纹理“同质性”随年龄、基底节区血管周围间隙评分（p < 0.01）和SVD评分（p < 0.05）而增加，高血压患者（p < 0.002）和腔隙性卒中患者（p = 0.04）的纹理同质性明显增高。高血压（74%患者）、WMH负荷（中位数=颅内体积的1.5±1.6%）和年龄（平均= 65.6岁，SD = 11.3）预测了对比前/后正常白质、WMH和脑卒中指数病变的变化。脑脊液信号随SVD增加而增加。随着SVD的增加，脑脊液的纹理“均匀性”增加，而随着WMH的增加，脑脊液的造影后变化一致，这表明纹理分析可能对血脑屏障完整性的研究有用。
We evaluate the alternative use of texture analysis for evaluating the role of blood–brain barrier (BBB) in small vessel disease (SVD). We used brain magnetic resonance imaging from 204 stroke patients, acquired before and 20 min after intravenous gadolinium administration. We segmented tissues, white matter hyperintensities (WMH) and applied validated visual scores. We measured textural features in all tissues pre- and post-contrast and used ANCOVA to evaluate the effect of SVD indicators on the pre-/post-contrast change, Kruskal–Wallis for significance between patient groups and linear mixed models for pre-/post-contrast variations in cerebrospinal fluid (CSF) with Fazekas scores. Textural “homogeneity” increase in normal tissues with higher presence of SVD indicators was consistently more overt than in abnormal tissues. Textural “homogeneity” increased with age, basal ganglia perivascular spaces scores (p < 0.01) and SVD scores (p < 0.05) and was significantly higher in hypertensive patients (p < 0.002) and lacunar stroke (p = 0.04). Hypertension (74% patients), WMH load (median = 1.5 ± 1.6% of intracranial volume), and age (mean = 65.6 years, SD = 11.3) predicted the pre/post-contrast change in normal white matter, WMH, and index stroke lesion. CSF signal increased with increasing SVD post-contrast. A consistent general pattern of increasing textural “homogeneity” with increasing SVD and post-contrast change in CSF with increasing WMH suggest that texture analysis may be useful for the study of BBB integrity.