Gempp Emmanuel, Sbardella Fabrice, Stephant Eric, Constantin Pascal, De Maistre Sebastien, Louge Pierre, Blatteau Jean-Eric
Department of Diving and Hyperbaric Medicine, Ste. Anne's Military Hospital, Toulon, France.
Aviat Space Environ Med. 2010 Nov;81(11):1008-12. doi: 10.3357/asem.2786.2010.
We conducted a controlled study to assess the prevalence of brain MRI hyperintense signals and their correlation with right-to-left shunting (RLS) in military divers.
We prospectively enrolled 32 asymptomatic military divers under 41 yr of age and 32 non-diving healthy subjects matched with respect to age and vascular disease risk factors. We examined both groups with a 3-Tesla brain MRI; RLS was detected using transcranial pulsed Doppler in divers only.
Hyperintense spots were observed in 43.7% of the divers and 21.8% of the control subjects. In particular, divers with significant shunting exhibited a higher prevalence of hyperintensities compared to those with slight or no RLS (75% vs. 25%, respectively). Linear trend analysis also revealed a positive correlation between focal white matter changes, determined using a validated visual rating scale and the RLS grade.
Healthy military divers with a hemodynamically relevant RLS have an increased likelihood of cerebral hyperintense spots compared to age-matched normal subjects. The clinical relevance of these MRI signal abnormalities and their causal relationship with diving remain unclear.
我们进行了一项对照研究，以评估军事潜水员脑磁共振成像（MRI）高信号的患病率及其与右向左分流（RLS）的相关性。
我们前瞻性纳入了32名年龄在41岁以下的无症状军事潜水员以及32名在年龄和血管疾病危险因素方面相匹配的非潜水健康受试者。我们对两组均进行了3特斯拉脑部MRI检查；仅对潜水员使用经颅脉冲多普勒检测RLS。
在43.7%的潜水员和21.8%的对照受试者中观察到高信号斑点。特别是，与轻度或无RLS的潜水员相比，有明显分流的潜水员高信号的患病率更高（分别为75%和25%）。线性趋势分析还显示，使用经过验证的视觉评分量表确定的局灶性白质变化与RLS分级之间呈正相关。
与年龄匹配的正常受试者相比，具有血流动力学相关RLS的健康军事潜水员出现脑高信号斑点的可能性增加。这些MRI信号异常的临床相关性及其与潜水的因果关系仍不清楚。
