1 University Paris Diderot, Sorbonne Paris Cité, UMR-S 1161 INSERM, Paris, France.
2 DHU NeuroVasc Sorbonne Paris Cité, Paris, France.
J Cereb Blood Flow Metab. 2018 Sep;38(9):1654-1663. doi: 10.1177/0271678X17690164. Epub 2017 Jan 27.
In Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL), by contrast to sporadic cerebral small vessel disease related to age and hypertension, white matter hyperintensities (WMH) are frequently observed in the white matter of anterior temporal poles, external capsules, and superior frontal regions. Whether these WMH (specific WMH) differ from those observed in other white matter areas (nonspecific WMH) remains unknown. Twenty patients were scanned to compare specific and nonspecific WMH using high-resolution images and analyses of relaxation times (T1: longitudinal relaxation time and T2*: effective transversal relaxation time). Specific WMH were characterized by significantly longer T1 and T2* (T1: 2309 ± 120 ms versus 2145 ± 138 ms; T2*: 40 ± 5 ms versus 35 ± 5 ms, p < 0.001). These results were not explained by the presence of dilated perivascular spaces found in the close vicinity of specific WMH. They were not either explained by the normal regional variability of T1 and T2* in the white matter nor by systematic imaging artifacts as shown by the study of 17 age- and sex-matched healthy controls. Our results suggest large differences in water content between specific and nonspecific WMH in CADASIL, supporting that mechanisms underlying WMH may differ according to their location.
在伴有皮质下梗死和白质脑病的常染色体显性脑动脉病（CADASIL）中，与年龄和高血压相关的散发性脑小血管病相比，前颞极、外囊和额上区的白质中经常观察到脑白质高信号（WMH）。这些 WMH（特定 WMH）是否与在其他白质区域观察到的WMH（非特定 WMH）不同尚不清楚。为了使用高分辨率图像和弛豫时间分析（T1：纵向弛豫时间和 T2*：有效横向弛豫时间）来比较特定和非特定 WMH，对 20 名患者进行了扫描。特定 WMH 的 T1 和 T2*（T1：2309±120ms 与 2145±138ms；T2*：40±5ms 与 35±5ms，p<0.001）明显更长。这些结果不能用在特定 WMH 附近发现的扩张的血管周围间隙来解释。它们也不能用白质中 T1 和 T2*的正常区域变异性来解释，也不能用 17 名年龄和性别匹配的健康对照者的研究来解释系统成像伪影。我们的结果表明，CADASIL 中特定和非特定 WMH 之间的含水量存在很大差异，支持WMH 发生的机制可能因位置而异。
