REGIONAL CEREBRAL BLOOD-FLOW IN PATIENTS WITH LEUKO-ARAIOSIS AND ATHEROSCLEROTIC CAROTID-ARTERY DISEASE
REGIONAL CEREBRAL BLOOD-FLOW IN PATIENTS WITH LEUKO-ARAIOSIS AND ATHEROSCLEROTIC CAROTID-ARTERY DISEASE
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DOI：
10.1001/archneur.1990.00530040034016
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发表时间：
1990-04-01
影响因子：
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通讯作者：
HEISS, WD
中科院分区：
文献类型：
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作者：
HERHOLZ, K;HEINDEL, W;HEISS, WD
对20例颈内动脉粥样硬化性疾病患者的脑白质病变（WMLs）与局部脑血流量（CBF）之间的关系进行了研究，脑白质病变（WMLs）由磁共振成像显示，局部脑血流量（CBF）由动态正电子发射断层扫描和[18 F]氟甲烷测量。小斑片状WML的范围与半球CBF 1之间没有相关性，但在5例多发性大或融合性病变患者中，半球CBF显着降低。当大的WML（> 5 mm）位于皮质正下方时，观察到明显的局灶性皮质CBF减少，而更深的白色物质中的大WML与更弥漫性的皮质灌注减少相关。没有证据表明随着WML或颈内动脉狭窄严重程度的增加，血管边缘区的CBF优先减少。先前短暂性脑缺血症状的一侧与半球CBF不对称性显著相关，但与WML不对称性和颈内动脉狭窄无关。从这些结果可以得出结论，磁共振成像显示的小斑片状WML的存在不能用作脑灌注受损的证据，而大病变表明影响皮质血流的临床相关脑血管疾病。
The relation between white-matter lesions (WMLs), demonstrated with magnetic resonance imaging, and regional cerebral blood flow (CBF), measured with dynamic positron emission tomography and [18F] fluoromethane, was investigated in 20 patients with atherosclerotic disease of the internal carotid artery. There was no correlation between the extent of small patchy WMLs and hemispheric CBF1 but hemispheric CBF was significantly reduced in 5 patients with multiple large or confluent lesions. Distinct focal cortical CBF reductions were observed when large WMLs (> 5 mm) were located directly beneath the cortex, whereas large WMLs in deeper white matter were associated with a more diffuse decrease of cortical perfusion. There was no evidence of preferential CBF reduction in vascular border zones with increasing severity of WMLs or stenosis of the internal carotid artery. The side of previous transient ischemic symptoms correlated significantly with hemispheric CBF asymmetries, but not with asymmetries of WMLs and internal carotid artery stenosis. It can be concluded from these results that the presence of small patchy WMLs shown by magnetic resonance imaging cannot be used as evidence of impaired cerebral perfusion, while large lesions indicate clinically relevant cerebrovascular disease affecting cortical blood flow.