Study of Enhanced Depth Imaging Optical Coherence Tomography in Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy.
Study of Enhanced Depth Imaging Optical Coherence Tomography in Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy.
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增强深度成像光学相干断层扫描在伴有皮质下梗死和白质脑病的常染色体显性遗传性脑动脉病中的研究
DOI：
10.4103/0366-6999.204935
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发表时间：
2017-05-05
影响因子：
6.1
通讯作者：
Yuan Y
中科院分区：
文献类型：
--
作者：
Fang XJ;Yu M;Wu Y;Zhang ZH;Wang WW;Wang ZX;Yuan Y
伴有皮质下梗死和白质脑病的常染色体显性遗传性脑动脉病（CADASIL）是一种由NOTCH 3基因突变引起的遗传性小动脉疾病。我们进行了增强深度成像光学相干断层扫描（EDI-OCT）来评估CADASIL患者的视网膜血管变化，并评估其与脑磁共振成像（MRI）结果的一致性。2015年1月至2016年8月，在北京大学第一医院招募了27名基因确诊的患者和同等数量的对照。所有患者均行颅脑7 T-MRI检查。评估Fazekas评分、小梗死和微出血的数量。所有患者和对照组均接受EDI-OCT测量中心凹下脉络膜厚度（SFCT）、内径和外径以及动脉和静脉壁厚度，以及内径（AVRin）和外径（AVRout）的动静脉比。分析视网膜血管变化与Fazekas评分、小梗死或微出血数量之间的关系。采用配对t检验比较患者与对照组之间的SFCT和视网膜血管测量数据。采用斯皮尔曼相关分析法探讨视网膜血管改变与MRI病变的相关性。CADASIL组平均SFCT（268.37 ± 46.50 μm）和平均动脉内径（93.46 ± 9.70 μm）显著低于对照组（P < 0.001，P = 0.048）。平均动脉外径（131.74 ± 10.87 μm），静脉内（128.99 ± 13.62 μm）和外径（164.82 ± 14.77 μm），平均动脉（19.13 ± 1.85 μm）和静脉（17.91 ± 2.76）μm，显著高于对照组（P = 0.023，P = 0.004，P <0.001，P < 0.001）。动脉内径（rs=-0.39，P = 0.044）、AVRin（rs=-0.65，P < 0.001）和AVRout（rs=-0.56，P = 0.002）与小梗死数量呈负相关。静脉内径（rs = 0.46，P = 0.016）与小梗死数目呈正相关。静脉内径（rs = 0.59，P = 0.002）、外径（rs = 0.47，P = 0.017）与脑微出血（CMB）例数呈正相关。AVRin（rs=-0.52，P = 0.007）和AVRout（rs=-0.40，P = 0.048）与CMB数量呈负相关。使用EDI-OCT的视网膜血管测量与MRI参数适度相关。EDI-OCT可能是CADASIL患者的有用评估工具。
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary small artery disease caused by NOTCH3 gene mutation. We performed enhanced depth imaging optical coherence tomography (EDI-OCT) to evaluate the retinal vessel changes in CADASIL patients and assessed their consonance with brain magnetic resonance imaging (MRI) findings. Of 27 genetically confirmed patients and an equal number of controls were recruited at the Peking University First Hospital from January 2015 to August 2016. All patients underwent 7T-MRI of the brain. Fazekas score, number of small infarcts and microbleeds were evaluated. All patients and controls underwent EDI-OCT to measure subfoveal choroidal thickness (SFCT), inner and outer diameters as well as arterial and venous wall thickness, and arterial venous ratio of the inner (AVRin) and outer diameters (AVRout). The relation between retinal vessel changes and Fazekas scores, numbers of small infarcts, or microbleeds was analyzed. Paired t-test was used to compare the SFCT and retinal vessel measurement data between patients and controls. Spearman's correlation was used to investigate the correlation between retinal vessel changes and MRI lesions. In CADASIL patients, mean SFCT (268.37 ± 46.50 μm) and mean arterial inner diameter (93.46 ± 9.70 μm) were significantly lower than that in controls (P < 0.001, P = 0.048, respectively). Mean arterial outer diameter (131.74 ± 10.87 μm), venous inner (128.99 ± 13.62 μm) and outer diameter (164.82 ± 14.77 μm), and mean arterial (19.13 ± 1.85 μm) and venous (17.91 ± 2.76 μm) wall thickness were significantly higher than that in controls (P = 0.023, P = 0.004, P < 0.001, P < 0.001, respectively). Arterial inner diameter (rs= −0.39, P = 0.044), AVRin (rs= −0.65, P < 0.001), and AVRout (rs= −0.56, P = 0.002) showed a negative correlation with the number of small infarcts. Venous inner diameter (rs = 0.46, P = 0.016) showed a positive correlation with the number of small infarcts. Venous inner diameter (rs = 0.59, P = 0.002), outer diameter (rs = 0.47, P = 0.017), showed a positive correlation with the number of cerebral microbleeds (CMBs). AVRin (rs= −0.52, P = 0.007) and AVRout (rs= −0.40, P = 0.048) showed a negative correlation with the number of CMBs. Measurement of retinal vessels using EDI-OCT correlates moderately well with MRI parameters. EDI-OCT might be a useful evaluation tool for CADASIL patients.