From the C.J. Gorter Center for High-Field-Strength MRI (S.v.R., A.M.v.O., M.J.V., A.G.W., M.A.v.B., J.v.d.G.), Department of Radiology (S.v.R., A.M.v.O., M.J.V., A.G.W., M.A.v.B., J.v.d.G.), and Department of Gerontology and Geriatrics (G.J.B.), Leiden University Medical Center, PO Box 9600, C3-Q, 2300 RC Leiden, the Netherlands; Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands (J.D.C.G., W.M.v.d.F., P.S.); Departments of Radiology (F.B.) and Epidemiology and Biostatistics (W.M.v.d.F.), VU University Medical Center, Amsterdam, the Netherlands; and Department of Gerontology and Geriatrics, Bronovo Hospital, Den Haag, the Netherlands (G.J.B.).
Radiology. 2014 Jan;270(1):205-11. doi: 10.1148/radiol.13130743. Epub 2013 Oct 28.
To assess the prevalence and number of cortical microinfarcts in patients with Alzheimer disease (AD) by using a 7-T magnetic resonance (MR) imaging system, to assess the independent association of cortical microinfarcts with cognitive dysfunction, and to investigate potential confounding effects of the coexisting presence of cerebral amyloid angiopathy (CAA).
The local institutional review board approved this study. In all cases, informed consent was obtained. High-spatial-resolution fluid-attenuated inversion recovery and T2*-weighted images were acquired in 14 AD patients and 18 control subjects to assess the presence of microinfarcts and microbleeds. Presence of CAA was assessed according to the Boston criteria. Image analysis was performed independently by two reviewers. Mann-Whitney U test was performed to assess differences in number of microinfarcts between groups. Negative binomial regression models were used to assess the association between diagnosis of AD and diagnosis of CAA and number of microinfarcts, between diagnosis of AD and number of microbleeds and number of microinfarcts, and between cognitive function and number of microinfarcts, all corrected for age and sex.
Interobserver agreement was excellent for detecting microinfarcts (κ = 0.91) (P < .001). Patients with AD demonstrated higher number (P = .005) of microinfarcts (mean, 7.2) compared with control subjects (mean, 1.8). Negative binomial regression models showed an independent association between AD and number of microinfarcts (P = .006) and a trend for CAA and microinfarcts (P = .052). A negative correlation was found between cognitive function and the number of microinfarcts (P = .009).
Patients with AD show more microinfarcts than do control subjects, the number of microinfarcts correlates with global cognitive performance, and the presence of microinfarcts was mainly AD rather than CAA related.
使用 7T 磁共振（MR）成像系统评估阿尔茨海默病（AD）患者皮质微梗死的发生率和数量，评估皮质微梗死与认知功能障碍的独立相关性，并研究共存脑淀粉样血管病（CAA）的潜在混杂影响。
本研究经当地机构审查委员会批准，所有病例均获得患者知情同意。14 例 AD 患者和 18 例对照组均行高空间分辨率液体衰减反转恢复和 T2*-加权成像，以评估微梗死和微出血的存在。根据波士顿标准评估 CAA 的存在。图像分析由两名独立的审查员进行。采用 Mann-Whitney U 检验比较两组间微梗死数量的差异。采用负二项回归模型评估 AD 诊断与 CAA 诊断和微梗死数量、AD 诊断与微出血数量和微梗死数量之间的相关性，以及认知功能与微梗死数量之间的相关性，所有相关性均校正年龄和性别因素。
观察者间检测微梗死的一致性极好（κ=0.91）（P＜.001）。AD 患者的微梗死数量（平均 7.2）高于对照组（平均 1.8）（P=.005）。负二项回归模型显示 AD 与微梗死数量之间存在独立相关性（P=.006），CAA 与微梗死之间存在相关性趋势（P=.052）。认知功能与微梗死数量之间存在负相关（P=.009）。
AD 患者的微梗死数量多于对照组，微梗死数量与整体认知功能相关，且微梗死的发生主要与 AD 相关，而不是 CAA。
