Characterization of white matter damage in ischemic leukoaraiosis with diffusion tensor MRI
Characterization of white matter damage in ischemic leukoaraiosis with diffusion tensor MRI
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DOI：
10.1161/01.str.30.2.393
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发表时间：
1999-02-01
期刊：
影响因子：
8.3
通讯作者：
Markus, HS
中科院分区：
文献类型：
--
作者：
Jones, DK;Lythgoe, D;Markus, HS
背景和目的：缺血性脑白质疏松症的神经病理学改变的信息仅在死后才能获得，并且关于疾病早期的组织学表现的数据有限。扩散张量成像允许确定扩散的方向性，其在白色物质束的方向上更大。因此，该技术可能会显示损失的各向异性（定向扩散）脑白质疏松症，方法9例缺血性脑白质疏松症（放射性脑白质疏松症和临床腔隙性中风）和10个年龄匹配的对照进行了研究。进行扩散张量成像，并构建扩散轨迹和分数各向异性图。平均值的痕迹和分数的各向异性确定在标准区域的前部和后部的白色问题在两个hemisales.Results-In缺血性脑白质疏松症的所有患者，一个特征性的异常模式被发现，与损失的各向异性和增加痕迹的白色问题。例如，在右前白色物质中，患者的平均（SD）trace/3为1.12（0.33）× 10（-3）mm（2）s（-1），对照组为0.75（0.11）（P = 0.001）。在同一区域，各向异性分数在患者组为0.53（0.11），在对照组为0.78（0.09）（P < 0.001）。在白色物质区域内，平均扩散率和各向异性之间存在很强的负相关性（r =-0.92，P < 0.0001）。获得的“体内组织学”信息可能有助于监测疾病进展和研究可能存在的认知障碍的发病机制。
Background and Purpose-Information on the neuropathological changes underlying ischemic leukoaraiosis is only available postmortem, and there are limited data on histological appearances early in the disease. Diffusion tensor imaging allows determination of the directionality of diffusion, which is greater in the direction of white matter bundles. Therefore, the technique might be expected to show loss of anisotropy (directional diffusion) in leukoaraiosis,Methods-Nine patients with ischemic leukoaraiosis (radiological leukoaraiosis and clinical lacunar stroke) and 10 age-matched controls were studied. Diffusion tensor imaging was performed, and maps of diffusion trace and fractional anisotropy were constructed. Mean values of trace and fractional anisotropy were determined in standard regions of the anterior and posterior white matter in both hemispheres.Results-In all patients with ischemic leukoaraiosis, a characteristic abnormal pattern was found, with loss of anisotropy and increased trace in the white matter. For example, in the fight anterior white matter mean (SD) trace/3 was 1.12 (0.33) X 10(-3) mm(2) s(-1) in patients and 0.75 (0.11) in controls (P = 0.001). In the same region, fractional anisotropy was 0.53 (0.11) in patients and 0.78 (0.09) in controls (P < 0.001). Within the white matter regions, there was a strong negative correlation between mean diffusivity and anisotropy (r = -0.92, P < 0.0001).Conclusions-The characteristic pattern found on diffusion tensor imaging in this patient group is consistent with axonal loss and gliosis leading to impairment to and loss of directional diffusion. The "in vivo histological" information obtained may be useful in monitoring disease progression and in investigating the pathogenesis of the cognitive impairment that may be present.