Imaizumi Toshio, Honma Toshimi, Horita Yoshifumi, Chiba Masahiko, Kawamura Maiko, Miyata Kei, Kohama Ikuhide, Niwa Jun
Department of Neurosurgery, Kushiro City General Hospital, Kushiro, Hokkaido, Japan.
J Neuroimaging. 2007 Jul;17(3):204-10. doi: 10.1111/j.1552-6569.2007.00090.x.
Dot-like low-intensity spots (dot-like hemosiderin spots: dotHSs) on gradient echo T2*-weighted (-w) brain magnetic resonance imaging (MRIs) are frequently associated with cerebral small vessel disease (SVD), including deep intracerebral hemorrhages and lacunar infarctions. This study investigated how numbers of newly appeared dotHSs contribute to recurrent SVD.
We prospectively analyzed numbers of newly appeared dotHSs in 12 patients with prior SVD (8 males, 4 females; mean 67.6 +/- 10.7 years old) readmitted with recurring SVD between October 2001 and March 2003. Numbers of appeared dotHSs per year were counted on T2*-w MRI scans after SVD recurrence and compared to previous MRIs. Seventy-one outpatients (35 males, 36 females; mean 64.3 +/- 9.6 years old) with histories of intracerebral hemorrhages (ICH) that came to the hospital during the study period served as controls. The hazard ratio (HR) for recurrence was estimated from a multivariate logistic regression model, using the number of appeared dotHSs (per year) and other risk factors.
Multivariate analyses revealed that an elevated rate of recurrence was found in patients with substantial numbers of appeared dotHSs (>or=5/year) (HR, 7.34; P= 0.0008). We also analyzed factors associated with the numbers of appeared dotHSs. A number of appeared dotHSs (>or=5/year) was significantly and independently associated with the initial number of dotHSs (>or=10) on T2*-w MRIs following the first SVD (HR, 18.6; P= 0.0001).
Though a small sample size limited the power of our analyses, our findings suggest that a number of newly appeared dotHSs may be associated with SVD recurrence.
梯度回波T2*加权脑磁共振成像（MRI）上的点状低强度斑点（点状含铁血黄素斑点：dotHSs）常与脑小血管疾病（SVD）相关，包括深部脑出血和腔隙性脑梗死。本研究调查了新出现的dotHSs数量如何导致SVD复发。
我们前瞻性分析了2001年10月至2003年3月期间因SVD复发再次入院的12例既往有SVD的患者（8例男性，4例女性；平均年龄67.6±10.7岁）中新出现的dotHSs数量。在SVD复发后的T2*加权MRI扫描上计算每年出现的dotHSs数量，并与之前的MRI进行比较。71例在研究期间因脑出血（ICH）病史前来医院就诊的门诊患者（35例男性，36例女性；平均年龄64.3±9.6岁）作为对照。使用每年出现的dotHSs数量和其他危险因素，通过多变量逻辑回归模型估计复发的风险比（HR）。
多变量分析显示，出现大量dotHSs（≥5/年）的患者复发率升高（HR，7.34；P = 0.0008）。我们还分析了与出现的dotHSs数量相关的因素。出现大量dotHSs（≥5/年）与首次SVD后T2*加权MRI上的初始dotHSs数量（≥10）显著且独立相关（HR，18.6；P = 0.0001）。
尽管样本量较小限制了我们分析的效力，但我们的研究结果表明，新出现的dotHSs数量可能与SVD复发相关。
