Chen Xiaohua, Wen Wei, Anstey Kaarin J, Sachdev Perminder S
Neuropsychiatric Institute, Euroa Centre, Prince of Wales Hospital, Barker Street, Randwick NSW 2031, Australia.
Neurology. 2009 Jul 28;73(4):266-72. doi: 10.1212/WNL.0b013e3181aa52ea.
Lacunar infarcts are small cavitated lesions no larger than 2 cm in diameter. Although often asymptomatic, they have been suggested as an important pathologic substrate of vascular dementia. The prevalence and risk factor profile of lacunar infarction has been variously reported, but the incidence data are scarce for large community-based data.
Participants (n = 477) were recruited randomly from the electoral roll of community residents aged 60-64 years as part of the PATH Through Life Study. Demographic information and risk factor data were collected and MRI brain scans performed in two waves, 4 years apart. The number and locations of lacunar infarcts as well as other volumetric data were assessed on T1-weighted and T2-weighted fluid-attenuated inversion recovery images.
In wave 1, 37 (7.8%) participants had at least one lacunar infarct. New lacunar infarcts were detected in 6 (6/375, 1.6%) participants at wave 2. Lacunes present at wave 1 increased significantly in mean volume from 53.90 to 69.86 mm(3) over 4 years. Hypertension (odds ratio [OR] = 1.6; 95% confidence interval [CI] = 1.01-2.60), anterior ventricle-brain ratio (%) (OR = 1.02; CI = 1.003-1.036), and volume of white matter hyperintensities (OR = 4.9; CI = 1.53-15.80) were independently associated with the prevalence of lacunar infarction.
Lacunes were common incidental findings in the brains of individuals in their 60s, and their prevalence as well as size increased with age. Hypertension was the major treatable risk factor, and lacunar infarction was usually associated with severe white matter hyperintensities on T2-weighted imaging.
腔隙性脑梗死是直径不超过2厘米的小空洞性病变。尽管通常无症状，但它们被认为是血管性痴呆的重要病理基础。腔隙性梗死的患病率和危险因素特征已有多种报道，但基于大型社区数据的发病率数据却很稀少。
作为“人生之路研究”的一部分，从60 - 64岁社区居民的选举名册中随机招募参与者（n = 477）。收集人口统计学信息和危险因素数据，并在相隔4年的两个阶段进行脑部MRI扫描。在T1加权和T2加权液体衰减反转恢复图像上评估腔隙性梗死的数量和位置以及其他体积数据。
在第一阶段，37名（7.8%）参与者至少有一处腔隙性梗死。在第二阶段，6名（6/375，1.6%）参与者检测到新的腔隙性梗死。在第一阶段出现的腔隙在4年中平均体积从53.90立方毫米显著增加到69.86立方毫米。高血压（比值比[OR]=1.6；95%置信区间[CI]=1.01 - 2.60）、前脑室与脑的比例（%）（OR = 1.02；CI = 1.003 - 1.036）以及白质高信号体积（OR = 4.9；CI = 1.53 - 15.80）与腔隙性梗死的患病率独立相关。
腔隙在60多岁人群的大脑中是常见的偶然发现，其患病率和大小随年龄增长而增加。高血压是主要的可治疗危险因素，并且腔隙性梗死在T2加权成像上通常与严重的白质高信号相关。
