Vascular Dysfunction in Leukoaraiosis
Vascular Dysfunction in Leukoaraiosis
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DOI：
10.3174/ajnr.a4888
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发表时间：
2016-12-01
影响因子：
3.5
通讯作者：
Mikulis, D. J.
中科院分区：
文献类型：
--
作者：
Sam, K.;Crawley, A. P.;Mikulis, D. J.
背景与目的：白质变病的发病机制一直存在争议。这项工作解决了一个研究较少的机制，脑血管反应性，它可能在这种疾病的发病机制中起主导作用。我们的目的是评估血流失调及其与白质变病的关系。材料与方法：在75例老年白质病变患者（年龄50-91岁，男性40例）中，脑血管反应性，即血氧水平依赖于3T MR成像信号对动脉二氧化碳分压持续阶跃变化的响应，通过白质高信号及其对侧空间同源的正常白质测量。通过弥散（n = 75）、定量T2 （n = 54）和DSC灌注MRI指标（n = 25）对白化病变区域进行额外的定量评估。结果：将白质高信号与对侧正常白质相比较，脑血管反应性平均降低61.2%+/- 22.6%，分数各向异性降低44.9% +/- 6.9%，CBF降低10.9%+/- 11.9%。T2高61.7%+/- 13.5%，平均扩散率高59.0%+/- 11.7%，最大时间高44.4%+/- 30.4%，TTP高6.8%+/- 5.8%
BACKGROUND AND PURPOSE: The pathogenesis of leukoaraiosis has long been debated. This work addresses a less well-studied mechanism, cerebrovascular reactivity, which could play a leading role in the pathogenesis of this disease. Our aim was to evaluate blood flow dysregulation and its relation to leukoaraiosis.MATERIALS AND METHODS: Cerebrovascular reactivity, the change in the blood oxygen level dependent 3T MR imaging signal in response to a consistently applied step change in the arterial partial pressure of carbon dioxide, was measured in white matter hyperintensities and their contralateral spatially homologous normal-appearing white matter in 75 older subjects (age range, 50-91 years; 40 men) with leukoaraiosis. Additional quantitative evaluation of regions of leukoaraiosis was performed by using diffusion (n = 75), quantitative T2 (n = 54), and DSC perfusion MRI metrics (n = 25).RESULTS: When we compared white matter hyperintensities with contralateral normal-appearing white matter, cerebrovascular reactivity was lower by a mean of 61.2%+/- 22.6%, fractional anisotropy was lower by 44.9 %+/- 6.9%, and CBF was lower by 10.9%+/- 11.9%. T2 was higher by 61.7%+/- 13.5%, mean diffusivity was higher by 59.0%+/- 11.7%, time-to-maximum was higher by 44.4%+/- 30.4%, and TTP was higher by 6.8%+/- 5.8% (all P