University Health Network, Toronto Western Hospital, Department of Medical Imaging, 399 Bathurst St, Toronto, M5T 2S8 ON, Canada.
J Neurol Neurosurg Psychiatry. 2010 Mar;81(3):290-3. doi: 10.1136/jnnp.2009.188078.
The physiological impact of severely impaired cerebral autoregulatory vascular reactivity on cortical integrity is unknown. The purpose of this study is to determine the relationship between severe impairment of autoregulatory flow control associated with steal phenomenon and its impact on cortical thickness.
250 blood oxygen level dependent (BOLD) MRI cerebrovascular reactivity (CVR) studies were reviewed in order to identify subjects with severe unilateral exhausted cerebrovascular reserve demonstrating steal physiology but with normal appearing cortex on fluid attenuated inversion recovery imaging. 17 patients meeting the inclusion criteria were identified. A reconstructed inflated cortical surface map was created for every subject using Freesurfer software (http://surfer.nmr.mgh.harvard.edu/). The region of interest (ROI) reflecting the steal physiology was determined by overlaying the subject's CVR map on to the cortical surface map. This ROI was compared with the corresponding area in the healthy hemisphere which provided control cortical thickness measurement in each subject.
The hemisphere with steal physiology showed an 8% thinner cortex (2.23+/-0.28 mm) than the corresponding healthy hemisphere (2.42+/-0.23 mm) (p=0.0005).
Our findings indicate that a spatial correspondence exists between impairment of autoregulatory capacity with steal physiology and cortical thinning.
严重受损的脑自动调节血管反应性对皮质完整性的生理影响尚不清楚。本研究的目的是确定与盗血现象相关的自动调节血流控制严重受损及其对皮质厚度的影响之间的关系。
为了确定存在严重单侧耗尽脑血管储备功能但在液体衰减反转恢复成像上显示正常皮质的患者，我们回顾了 250 例血氧水平依赖（BOLD）MRI 脑血管反应性（CVR）研究。确定了符合纳入标准的 17 例患者。使用 Freesurfer 软件（http://surfer.nmr.mgh.harvard.edu/）为每位患者创建了重建的膨胀皮质表面图。通过将患者的 CVR 图叠加到皮质表面图上，确定反映盗血生理学的感兴趣区域（ROI）。该 ROI 与健康半球的相应区域进行比较，为每个患者提供对照皮质厚度测量。
盗血生理学的半球皮质比相应的健康半球薄 8%（2.23+/-0.28 毫米）（p=0.0005）。
我们的发现表明，自动调节能力受损与盗血生理学之间存在空间对应关系，并且与皮质变薄有关。
