Micro-MRI improves the accuracy of clinical diagnosis in cerebral small vessel disease.
Micro-MRI improves the accuracy of clinical diagnosis in cerebral small vessel disease.
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Micro-MRI提高了脑小血管疾病中临床诊断的准确性。
DOI：
10.1093/braincomms/fcab070
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发表时间：
2021
影响因子：
4.8
通讯作者：
Tomimoto H
中科院分区：
文献类型：
--
作者：
Ishikawa H;Niwa A;Kato S;Ii Y;Shindo A;Matsuura K;Nishiguchi Y;Tamura A;Taniguchi A;Maeda M;Hashizume Y;Tomimoto H
即使进行死后病理学检查，也只能提供有限的体内临床信息病灶信息。脑小血管疾病，这是与老龄化，痴呆和中风，突出了在体内放射学检查检测到的病变的明确诊断的困难。我们使用离体MRI进行了一项放射学-病理学比较研究，以检查小的脑病变。研究了4例在体内MRI上检测到小血管病变的患者。揭示了体内MRI检测病变的确切病理学结果。发病17天后的缺血性病变显示过氧化物酶、分化簇204和胶质细胞酸性蛋白阳性，表明无菌性炎症和神经保护反应。皮质浅表铁质沉着症下方的皮质微梗死与脑淀粉样血管病患者的浅表层炎症相关;在该患者中，离体MRI上皮质浅表铁质沉着症的双线性轨道样外观与软脑膜上和皮质层II-III内的铁沉积相一致。在体内MRI检测到的脑微出血被发现是异质性的。在体内MRI检测到的脑微出血被发现是静脉血管瘤。此外，神经病理学证实栓塞性脑微出血首次使用这种方法检测。我们的研究结果表明，在体内MRI检测到的脑叶微出血可能是由非脑淀粉样血管病病因引起的，如微栓塞和静脉血管瘤。静脉血管瘤和栓塞性微出血可能在体内MRI上模拟脑淀粉样血管病标志物。为了阐明这些病变的临床重要性，我们应该在大量健康个体和有心脏危险因素的患者中调查其发生率和频率。因此，我们提供的证据表明，离体micro-MRI提高了小血管疾病的临床诊断。本研究介绍了使用micro-MRI进行放射病理学比较研究的独特方法。将micro-MRI用作桥梁，以评估体内MRI和神经病理学的结果。描述了在体内MRI检测到的小血管疾病的新神经病理学发现，如脑微出血、皮质微梗死和皮质浅表铁质沉着症。
Even with postmortem pathological examination, only limited information is provided of the foci of in vivo clinical information. Cerebral small vessel disease, which is associated with ageing, dementia and stroke, highlights the difficulty in arriving at a definitive diagnosis of the lesions detected on in vivo radiological examination. We performed a radiological−pathological comparative study using ex vivo MRI to examine small cerebral lesions. Four patients with small vessel disease lesions detected on in vivo MRI were studied. Exact pathological findings of in vivo MRI-detected lesions were revealed. The ischaemic lesion after 17 days from onset showed positivity for peroxiredoxin, cluster of differentiation 204 and glial fibrillary acidic protein, indicating sterile inflammation and neuroprotective reaction. Cortical microinfarcts beneath the cortical superficial siderosis were associated with inflammation from the superficial layer in a patient with cerebral amyloid angiopathy; in this patient, a bilinear track-like appearance of the cortical superficial siderosis on the ex vivo MRI was compatible with iron deposition on the pia matter and within cortical layers II–III. An in vivo MRI-detected cerebral microbleed was revealed to be heterogeneous. An in vivo MRI-detected cerebral microbleed was revealed to be a venous angioma. Furthermore, a neuropathologically confirmed embolic cerebral microbleed was firstly detected using this method. Our results suggest that in vivo MRI-detected lobar cerebral microbleeds can be caused by non-cerebral amyloid angiopathy aetiologies, such as microembolism and venous angioma. Venous angioma and embolic microbleeds may mimic cerebral amyloid angiopathy markers on in vivo MRI. To clarify the clinical importance of these lesions, we should investigate their rate and frequency in a large cohort of healthy individuals and patients with cardiac risk factors. Thus, we provide evidence that ex vivo micro-MRI improves the clinical diagnosis of small vessel diseases. This study introduces unique method for radiological−pathological comparative research using micro-MRI. The micro-MRI was used as bridge to assess findings of in vivo MRI and neuropathology. Novel neuropathological findings of in vivo MRI-detected small vessel disease, such as cerebral microbleeds, cortical microinfarcts, and cortical superficial siderosis were described.
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DOI：
10.1177/1747493018799962
发表时间：
2019-04
期刊：
International journal of stroke : official journal of the International Stroke Society
影响因子：
--
作者：
Humphreys CA;Jansen MA;Muñoz Maniega S;González-Castro V;Pernet C;Deary IJ;Al-Shahi Salman R;Wardlaw JM;Smith C
通讯作者：
Smith C
影响因子：
29
作者：
Charidimou A;Martinez-Ramirez S;Reijmer YD;Oliveira-Filho J;Lauer A;Roongpiboonsopit D;Frosch M;Vashkevich A;Ayres A;Rosand J;Gurol ME;Greenberg SM;Viswanathan A
通讯作者：
Viswanathan A
影响因子：
8.3
作者：
Takasugi, Junji;Miwa, Kaori;Mochizuki, Hideki
通讯作者：
Mochizuki, Hideki
影响因子：
6.3
作者：
van Veluw, Susanne J.;Zwanenburg, Jaco J. M.;Biessels, Geert Jan
通讯作者：
Biessels, Geert Jan
影响因子：
5
作者：
Fernando, MS;O'Brien, JT;Ince, PG
通讯作者：
Ince, PG