Spilt A, Goekoop R, Westendorp R G J, Blauw G J, de Craen A J M, van Buchem M A
Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.
AJNR Am J Neuroradiol. 2006 Oct;27(9):1964-8.
Our aim was to assess whether presumed histologic heterogeneity of age-related white matter hyperintensities (WMH) is reflected in quantitative magnetization transfer imaging measures.
From a group of patients participating in a double-blind placebo-controlled multicenter study on the effect of pravastatin (PROSPER), we selected 56 subjects with WMH. WMH were classified as periventricular WMH (PVWMH) and deep WMH (DWMH). PVWMH were subclassified as irregular or smooth, depending on the aspect of their border. Signal intensity of WMH on T1-weighted images was scored as iso- or hypointense. The mean magnetization transfer ratio (MTR) value of different types of WMH was assessed and compared. As a control group, we selected 19 subjects with no or limited WMH.
Mean (SE) MTR of PVWMH (frontal, 31.2% [0.2%]; occipital, 32.2% [0.2%]) was lower than that of DWMH (33.7% [0.5%]). The mean MTR of frontal PVWMH (31.2% [0.2%]) was lower than that of occipital PVWMH (32.2% [0.2%]). Compared with occipital PVWMH, frontal PVWMH more often had a smooth lining (72% frontal versus 8% occipital) and an area with low signal intensity on T1-weighted images (76% frontal versus 35% occipital). MTR did not differ between smooth (31.1% [0.3%]) and irregular (31.6% [0.5%]) PVWMH.
Age-related WMH are heterogeneous, despite their similar appearance on T2-weighted images. By taking into account heterogeneity of age-related WMH, both in terms of etiology and in terms of severity of tissue destruction, one may obtain better understanding on the causes and consequences of these lesions.
我们的目的是评估年龄相关性白质高信号（WMH）假定的组织学异质性是否反映在定量磁化传递成像测量中。
从一组参与关于普伐他汀效果的双盲安慰剂对照多中心研究（PROSPER）的患者中，我们选取了56例有WMH的受试者。WMH被分类为脑室周围WMH（PVWMH）和深部WMH（DWMH）。PVWMH根据其边界情况进一步分为不规则或光滑型。T1加权图像上WMH的信号强度被评为等信号或低信号。评估并比较不同类型WMH的平均磁化传递率（MTR）值。作为对照组，我们选取了19例无或仅有少量WMH的受试者。
PVWMH（额叶，31.2%[0.2%]；枕叶，32.2%[0.2%]）的平均（标准误）MTR低于DWMH（33.7%[0.5%]）。额叶PVWMH的平均MTR（31.2%[0.2%]）低于枕叶PVWMH（32.2%[0.2%]）。与枕叶PVWMH相比，额叶PVWMH更常具有光滑的边界（额叶72%，枕叶8%）以及T1加权图像上低信号强度区域（额叶76%，枕叶35%）。光滑型（31.1%[0.3%]）和不规则型（31.6%[0.5%]）PVWMH的MTR无差异。
年龄相关性WMH是异质性的，尽管它们在T2加权图像上外观相似。通过考虑年龄相关性WMH在病因和组织破坏严重程度方面的异质性，人们可能会对这些病变的原因和后果有更好的理解。
