FURTHER OBSERVATIONS ON THE PATHOLOGY OF SUBCORTICAL LESIONS IDENTIFIED ON MAGNETIC-RESONANCE-IMAGING
FURTHER OBSERVATIONS ON THE PATHOLOGY OF SUBCORTICAL LESIONS IDENTIFIED ON MAGNETIC-RESONANCE-IMAGING
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DOI：
10.1001/archneur.1992.00530310095018
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发表时间：
1992-07-01
影响因子：
--
通讯作者：
AWAD, IA
中科院分区：
文献类型：
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作者：
CHIMOWITZ, MI;ESTES, ML;AWAD, IA
我们对连续7例死于非神经性原因的50岁以上患者的大脑进行了尸检、磁共振成像和病理检查。在每个患者中都发现了多个高信号的皮质下病变，总共29个病变进行了组织学检查(8个边缘，6个帽，6个点状病变，9个补片)。环状突起表现为室管膜下胶质细胞增厚和室管膜衬里缺失；斑片状病变伴有髓鞘苍白、胶质增厚和动脉硬化；点状病变以血管周围间隙扩张和血管周围间隙扩张为特征；斑片样病变伴有髓鞘苍白和血管周围间隙扩张。髓鞘苍白的图案决定了帽子和斑块的大小和形状。6个帽状物中的6个、6个斑点状病变中的3个和9个斑块中的3个发现了动脉硬化。这些数据表明：(1)每种类型的高信号皮质下病变具有明显的病理相关性；(2)动脉硬化并不总是与磁共振成像上所有类型的高信号皮质下病变相关；(3)髓鞘苍白似乎对1.5T的磁共振成像信号有贡献。
We performed postmortem magnetic resonance imaging and pathologic examinations on the brains of seven consecutive patients older than 50 years of age who died of non-neurologic causes. Multiple hyperintense subcortical lesions were identified in each patient, and a total of 29 lesions were examined histologically (eight rims, six caps, six punctate lesions, and nine patches). Rims were characterized by subependymal gliosis and loss of the ependymal lining; caps were associated with myelin pallor, gliosis, and arteriosclerosis; punctate lesions were characterized by dilated perivascular spaces and perivascular gliosis; and patches were associated with myelin pallor and dilated perivascular spaces. The pattern of myelin pallor defined the size and shape of caps and patches. Arteriosclerosis was identified in six of six caps, three of six punctate lesions, and in three of nine patches. These data indicate that (1) each type of hyperintense subcortical lesion has a distinct pathologic correlate; (2) arteriosclerosis is not invariably associated with all types of hyperintense subcortical lesions on magnetic resonance imaging; and (3) myelin pallor appears to contribute to the magnetic resonance imaging signal at 1.5 tesla.