Hypertension and Cerebral Diffusion Tensor Imaging in Small Vessel Disease
Hypertension and Cerebral Diffusion Tensor Imaging in Small Vessel Disease
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DOI：
10.1161/strokeaha.110.597237
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发表时间：
2010-12-01
期刊：
影响因子：
8.3
通讯作者：
de Leeuw, Frank-Erik
中科院分区：
文献类型：
--
作者：
Gons, Rob A. R.;de Laat, Karlijn F.;de Leeuw, Frank-Erik
背景和目的：高血压是脑小血管疾病的危险因素，包括白色病变（WML）和腔隙性梗死。这些病变经常在老年人的MRI扫描中观察到，并在认知能力下降中发挥作用。优选地，人们希望在液体衰减反转恢复可见宏观结构损伤发生之前评估高血压的影响，可能通过研究其对白色物质的微观结构完整性的影响。扩散张量成像提供了措施的结构integrity. Methods，在503例小血管疾病，年龄在50和85岁之间，我们横断面研究血压，高血压，高血压治疗状态和扩散张量成像参数之间的关系，在两个正常出现的白色物质（NAWM）和WMLs。所有受试者均行1.5T磁共振成像和弥散张量成像扫描。分数各向异性和平均扩散率计算在NAWM和WMLs.Results-Increased血压和高血压显着相关的分数各向异性较低的NAWM和WMLs和更高的平均扩散率在WMLs。对于高血压患者，与血压正常者相比，NAWM和WML的微结构完整性受损风险（各向异性分数）的比值比分别为3.1（95%CI：1.8至5.7）和2.1（95%CI：1.2至3.5）。接受治疗的非对照受试者的各向异性分数比值比为6.5（95% CI：3.3 - 12.7）和2.7（95%置信区间：1.5至5.1），分别在NAWM和WMLs，与normotensives. Conclusions相比，我们的数据表明，扩散张量成像可能是一个适当的工具，以监测血压的影响和对白色物质的完整性，可能甚至在流体衰减反转恢复的WML开发之前。（中风。2010;41：2801-2806.）
Background and Purpose-Hypertension is a risk factor for cerebral small vessel disease, which includes white matter lesions (WML) and lacunar infarcts. These lesions are frequently observed on MRI scans of elderly people and play a role in cognitive decline. Preferably, one would like to evaluate the effect of hypertension before fluid-attenuated inversion recovery visible macrostructural lesions occur, possibly by investigating its effect on the microstructural integrity of the white matter. Diffusion tensor imaging provides measures of structural integrity.Methods-In 503 patients with small vessel disease, aged between 50 and 85 years, we cross-sectionally studied the relation between blood pressure, hypertension, and hypertension treatment status and diffusion tensor imaging parameters in both normal-appearing white matter (NAWM) and WMLs. All of the subjects underwent 1.5-T MRI and diffusion tensor imaging scanning. Fractional anisotropy and mean diffusivity were calculated in both NAWM and WMLs.Results-Increased blood pressure and hypertension were significantly related to lower fractional anisotropy in both NAWM and WMLs and to higher mean diffusivity in WMLs. For hypertensives, odds ratios for the risk of impaired microstructural integrity (fractional anisotropy) were 3.1 (95% CI: 1.8 to 5.7) and 2.1 (95% CI: 1.2 to 3.5) in NAWM and WMLs, respectively, compared with normotensives. Fractional anisotropy odds ratios for treated uncontrolled subjects were 6.5 (95% CI: 3.3 to 12.7) and 2.7 (95% CI: 1.5 to 5.1) in NAWM and WMLs, respectively, compared with normotensives.Conclusions-Our data show that diffusion tensor imaging may be an appropriate tool to monitor the effect of blood pressure and the response to treatment on white matter integrity, probably even before the development of WMLs on fluid-attenuated inversion recovery. (Stroke. 2010;41:2801-2806.)