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脑微出血与基底动脉扩张性重构:一项磁共振成像研究。

Cerebral microbleeds and dilative remodeling of the basilar artery: a magnetic resonance imaging study.

机构信息

Department of Neurology, Showa University School of Medicine, Tokyo, Japan.

出版信息

J Stroke Cerebrovasc Dis. 2011 Sep-Oct;20(5):429-35. doi: 10.1016/j.jstrokecerebrovasdis.2010.02.015. Epub 2010 Sep 2.

Abstract

This study was conducted to examine the relationship between cerebral microbleeds (CMBs), one of the manifestations of small-vessel diseases (SVDs), and basilar artery (BA) dilatation on magnetic resonance imaging (MRI). Clinical information and MRI images were reviewed for 149 outpatients aged 46-90 years, excluding those who had a previous symptomatic cerebrovascular event. CMBs were evaluated on T2∗-weighted MRI, and BA diameters were measured as the maximal width of the flow void on axial T2-weighted MRI to assess dilatation. Patients were divided into 2 groups, with CMBs and without CMBs, and clinical information and BA diameters were compared between the groups. Regression analyses of the data also were performed. The 2 groups had significant differences in mean blood pressure (MBP), low-density lipoprotein (LDL) and uricemic acid levels, and BA diameter. Adjusted logistic regression analysis showed that MBP (odds ratio [OR], 1.059 per 1 mm Hg; 95% confidence interval [CI], 1.019-1.101; P = .0035), LDL (OR, 0.976 per 1 mg/dL; 95% CI, 0.960-0.994; P = .0072), and BA diameter (OR, 3.266 per 1 mm; 95% CI, 1.504-7.103; P = .0028) each had an independent association with the presence of CMB. Adjusted multiple regression analysis showed that only BA diameter (β coefficient, 0.240; 95% CI, 0.775-3.734; P = .0031) was independently associated with the number of CMBs. Our data indicate that CMB, a manifestation of SVD, shows a strong association with BA dilatation.

摘要

本研究旨在探讨脑微出血(CMBs)——小血管疾病(SVD)的一种表现——与磁共振成像(MRI)上基底动脉(BA)扩张之间的关系。我们对 149 名年龄在 46-90 岁的门诊患者的临床信息和 MRI 图像进行了回顾性分析,排除了有既往症状性脑血管事件的患者。CMBs 通过 T2*-加权 MRI 进行评估,BA 直径通过轴向 T2 加权 MRI 上的血流空洞最大宽度测量来评估扩张。将患者分为 CMB 组和无 CMB 组,比较两组间的临床资料和 BA 直径。对数据进行回归分析。两组的平均血压(MBP)、低密度脂蛋白(LDL)和尿酸水平以及 BA 直径存在显著差异。调整后的逻辑回归分析显示,MBP(每增加 1mmHg 的比值比 [OR],1.059;95%置信区间 [CI],1.019-1.101;P =.0035)、LDL(每增加 1mg/dL 的 OR,0.976;95% CI,0.960-0.994;P =.0072)和 BA 直径(每增加 1mm 的 OR,3.266;95% CI,1.504-7.103;P =.0028)与 CMB 的存在均有独立相关性。调整后的多元回归分析显示,只有 BA 直径(β系数,0.240;95% CI,0.775-3.734;P =.0031)与 CMB 数量有独立相关性。我们的数据表明,SVD 的一种表现形式 CMB 与 BA 扩张有很强的关联性。

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