Vernooij Meike W, van der Lugt Aad, Ikram Mohammad Arfan, Wielopolski Piotr A, Vrooman Henri A, Hofman Albert, Krestin Gabriel P, Breteler Monique M B
Department of Epidemiology & Biostatistics, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
J Cereb Blood Flow Metab. 2008 Feb;28(2):412-9. doi: 10.1038/sj.jcbfm.9600526. Epub 2007 Jul 11.
Reduced cerebral perfusion may contribute to the development of cerebrovascular and neurodegenerative diseases. Little is known on cerebral perfusion in the general population, as most measurement techniques are too invasive for application in large groups of healthy individuals. Total cerebral blood flow (tCBF) can be noninvasively measured by magnetic resonance imaging (MRI) but is highly correlated with brain volume. We calculated total brain perfusion by dividing tCBF by brain volume, and we investigated determinants of total brain perfusion in comparison with tCBF. Secondly, we studied whether persons with a low tCBF or low total brain perfusion have a larger volume of white matter lesions (WML). This study is based on 892 persons aged 60 to 91 years from the Rotterdam Study, a population-based cohort study. We performed two-dimensional (2D) phase-contrast MRI for tCBF measurement. Brain volume and WML volume were quantitatively assessed. Cardiovascular determinants were assessed by interview and physical examination. We assessed associations between cardiovascular determinants and flow measures with linear regression models, adjusted for age and sex. Associations between tCBF or total brain perfusion and WML volume were assessed using general linear models. We found that determinants of tCBF and total brain perfusion differed largely due to the large influence of brain volume on tCBF values. Persons with low total brain perfusion had a significantly larger WML volume compared with those with high total brain perfusion. Prospective studies are required to unravel whether hypoperfusion contributes to WML formation or that tissue damage, manifested by WML, leads to brain hypoperfusion.
脑灌注减少可能会促使脑血管疾病和神经退行性疾病的发生。由于大多数测量技术对于大量健康个体来说侵入性太强，因此对于一般人群的脑灌注情况知之甚少。全脑血流量（tCBF）可通过磁共振成像（MRI）进行无创测量，但与脑容量高度相关。我们通过将tCBF除以脑容量来计算全脑灌注，并与tCBF相比研究了全脑灌注的决定因素。其次，我们研究了tCBF或全脑灌注较低的人是否有更大体积的白质病变（WML）。本研究基于鹿特丹研究中的892名60至91岁的人群，这是一项基于人群的队列研究。我们进行二维（2D）相位对比MRI来测量tCBF。对脑容量和WML体积进行了定量评估。通过访谈和体格检查评估心血管决定因素。我们使用线性回归模型评估心血管决定因素与血流测量之间的关联，并对年龄和性别进行了调整。使用一般线性模型评估tCBF或全脑灌注与WML体积之间的关联。我们发现，由于脑容量对tCBF值的巨大影响，tCBF和全脑灌注的决定因素有很大差异。与全脑灌注高的人相比，全脑灌注低的人的WML体积明显更大。需要进行前瞻性研究来揭示灌注不足是否会导致WML形成，或者WML所表现出的组织损伤是否会导致脑灌注不足。
