Gebeily Souheil, Fares Youssef, Kordahi Manal, Khodeir Pierre, Labaki Ghattas, Fazekas Franz
1Neurology Division. Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon.
Int J Neurosci. 2014 Nov;124(11):799-805. doi: 10.3109/00207454.2014.884087. Epub 2014 Feb 14.
Cerebral white matter hyperdensities (WMH) are frequently reported on brain magnetic resonance images (MRI) of elderly people; its significance is still under debate.
WMH subtypes may correlate with vascular risk factors, such as aging, hypertension (HTN) and diabetes mellitus (DM). The suggested hypothesis was to find if any of the periventricular WMH (PVWMH) or the deep WMH (DWMH) would be significantly more correlated with the above vascular risk factors. According to the Fazekas semiquantitative rating scale, we classified WMH into four subtypes: (1) absence of WMH, (2) presence of DWML, (3) presence of PVWMH, (4) presence of both DWML and PVWML. The study was performed on 257 Lebanese inpatients aged 40 years and above who underwent a brain MRI, regardless of their underlying pathology and who were admitted to an Internal Medicine Department in Beirut. The study patients were categorized into five subgroups by age intervals of 10 years.
Mean age was 62; 54.1% were females; WMH were observed in 59.5% of study population; we found a linear correlation with WMH and aging with a clear shift for patients over age 60, reaching 84% in patients subgroup of 70-79-year-old and 94% patients subgroup over 80-year-old. PVWMH was found significantly more frequently and in linear correlation with aging and HTN. WMH were also found more frequently among the DM individuals.
From this first ever retrospective Lebanese study, WMH was reported increasingly with aging in accordance with data from the literature; PVWMH was found significantly more correlated with aging and HTN than was DWMH alone.
脑白质高信号(WMH)在老年人的脑磁共振成像(MRI)中经常被报道;其意义仍在争论中。
WMH亚型可能与血管危险因素相关,如衰老、高血压(HTN)和糖尿病(DM)。提出的假设是,研究脑室周围WMH(PVWMH)或深部WMH(DWMH)是否与上述血管危险因素有更显著的相关性。根据Fazekas半定量评分量表,我们将WMH分为四种亚型:(1)无WMH,(2)存在深部白质病变(DWML),(3)存在脑室周围WMH(PVWMH),(4)同时存在DWML和PVWML。该研究对257名年龄在40岁及以上的黎巴嫩住院患者进行,这些患者接受了脑部MRI检查,无论其潜在病理情况如何,且均入住贝鲁特的内科病房。研究患者按10岁的年龄间隔分为五个亚组。
平均年龄为62岁;54.1%为女性;59.5%的研究人群观察到WMH;我们发现WMH与衰老呈线性相关,60岁以上患者有明显变化,在70 - 79岁患者亚组中达到84%,80岁以上患者亚组中达到94%。发现PVWMH出现频率显著更高,且与衰老和HTN呈线性相关。在糖尿病患者中也更频繁地发现WMH。
从这项首次针对黎巴嫩人的回顾性研究来看,与文献数据一致,WMH随年龄增长而增加;发现PVWMH与衰老和HTN的相关性比单独的DWMH更显著。