高齢者の大脳白質にMRI T_2強調画像にて高頻度に認められる高信号域の解明

老年人脑白质MRI T_2加权图像中常见高信号区域的阐明

• 批准号: 05670548
• 负责人: 岡本 幸市
• 金额: $ 1.28万
• 依托单位: Gunma University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (C)
• 财政年份: 1993
• 资助国家: 日本
• 起止时间: 1993 至 无数据
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-05670548/
• 关键词: MRI; 脳梗塞; 病理

老年病研究所附属病院において剖検された症例の中で,死亡前のMRI(0.2T)検査で大脳白質にT2強調画像(TR2000/TE110)にて散在性に高信号域がみられた症例を対象に検索した.症例は6例(53〜88歳,MRI撮像から死亡までの期間は16日以内が4例,他の2例は41日と4カ月.1例は固定後にもMRIを撮像)で,約2週間ホリマリンに固定後,MRIの断面にできるだけ沿うように5mm間隔で水平断し,写真撮影をした後,型の如くパラフィン包埋大切片を作成した。HE,HE+LFB,Mallory染色,Bielshowsky染色,抗GFAPと抗neurofilament抗体を用いた免疫染色などを施し,MRI画像所見,肉眼所見,組織所見を対比検討した.結果:(1)大脳白質にみられたT2強調画像での高信号域の中で,6〜7mm大以上で比較的強い信号強度で不規則な形態を示すものの大半は陳旧性の小梗塞であった。(2)MRI上約2〜5mm大で脳室と同程度の高信号を示す部位に相当するところには肉眼的に明らかな梗塞巣はなく,対応すると考えられる部位には血管を中心に髄鞘の淡明化がみられた.髄鞘・軸索の断裂や星膠細胞の増生はみられなかった.これらの近傍の大脳白質の血管には広汎に動脈壁の肥厚や小血管周囲の海綿状変化もみられた.(3)被殻などにみられような大きな血管周囲腔(Virchow-Robin腔)の拡大はこのような部位にはみられなかった.考察と結論:高齢者で高頻度にみられる大脳白質のT2強調画像上の微細な高信号域は,主として小梗塞と血管周囲の淡明化よりなっており,両者はMRI上,大きさ・形態・信号強度などよりほぼ区別できた.血管周囲の髄鞘の淡明化は,単なる加齢的変化ではなく,病理学的には動脈壁の肥厚を基盤とした循環不全に起因した病変を反映しているものと考えられた.追記:研究発表覧には補助金にて購入した機器を利用して行った研究業績も記入した.

An autopsy was performed in the affiliated hospital of the Institute of Geriatrics. MRI (0.2T), T2-strong portrait (TR2000/TE110), scattered high-signal domain, high-signal domain, premortem, postmortem, postmortem and postmortem. There were 6 cases (53-88 years old, 4 cases within 16 days, 2 cases from 41 days to 4 months, and 1 case from MRI after fixation) in 6 cases (53-88 years old, 4 cases within 16 days) in 6 cases (53-88 years old, 4 cases within 16 days, 2 cases from 41 days to 4 months, and 1 case from fixed to 4 months). After fixed, the cross-section of MRI was cut off along the level of 5mm interval, and the image was made into a large slice after the image summary was completed. HE,HE+LFB,Mallory staining, Bielshowsky staining, anti-GFAP and anti-neurofilament antibodies were detected by immunostaining. The images of MRI, naked eyes and tissues were much higher than those of normal tissues. Results: (1) the intensity of the T2 image in the high signal field, and the intensity of the signal above the 6~7mm ratio does not show that most of the old cases have small infarctions. (2) on MRI, the same degree of high signal intensity indicates that the area is quite bright and infarcted with the naked eye, and the vascular center is diluted in the center of the blood vessel. The sheath cable is broken, the star cells are broken, and the cells are broken. The wall of the small blood vessel is thickened, and the small blood vessel is surrounded by a seawall. (3) the perivascular lumen (Virchow-Robin cavity) is located in the perivascular cavity (Virchow-Robin cavity). The results of the investigation: the patients with high blood pressure showed high intensity intensity, large white signal T2 intensity, micro-intensity high-signal domain on the portrait, small infarct, vascular perivascular desalination, vascular desalination, and MRI. The shape signal intensity of the large area was different. The perivascular sheath is diluted, the vascular wall is thickened, and the cause of the disease is reflected in the pathology. Follow-up: the research table, financial aid, and registration machines are used to record the records of the research staff.

项目成果

Okamoto K et al: "Oculomotor nuclear pathology in amyotrophic lateral sclerosis" Acta Neuropathologica. 85. 458-462 (1993)

Okamoto K 等人：“肌萎缩侧索硬化症的动眼神经病理学”《神经病理学报》。

Okamoto K et al: "Bunina bodies in amyotrophic lateral sclerosis immunostained with rabbit anti-cystatin C serum" Neuroscience Letters. 162. 125-128 (1993)

Okamoto K 等人：“肌萎缩侧索硬化症中的布尼纳小体用兔抗胱抑素 C 血清进行免疫染色”《神经科学快报》。

Hirai S & Okamoto K: "Amyloid β/A_4 peptide associated with Alzheimer's disease and cerebral amyloid angiopathy" Internal medicine. 32. 923-925 (1993)

Hirai S 和 Okamoto K：“与阿尔茨海默病和脑淀粉样血管病相关的淀粉样蛋白 β/A_4 肽”内科医学。 32. 923-925 (1993)