Departments of Neurology, National Taiwan University Hospital, Taipei, Taiwan.
Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan.
Sci Rep. 2017 Mar 17;7:44715. doi: 10.1038/srep44715.
The underlying pathology of cerebral microbleeds (CMBs) with mixed lobar and deep distribution remains contentious. The aim of this study was to correlate CMBs distribution to β-amyloid burden in patients with primary intracerebral hemorrhage (ICH). Fourty-seven ICH patients underwent magnetic resonance susceptibility-weighted imaging and C-Pittsburgh Compound B positron emission tomography. The amyloid burden was expressed as standardized uptake value ratio with reference to cerebellum, and presented as median (interquartile range). Patients were categorized into the lobar, mixed (both lobar and deep regions), and deep types of CMB. Comparing the lobar (17%), mixed (59.6%) and deep (23.4%) CMB types, the global amyloid burden was significantly higher in the mixed type than the deep type (1.10 [1.03-1.25] vs 1.00 [0.97-1.09], p = 0.011), but lower than in the lobar type (1.48 [1.18-1.50], p = 0.048). On multivariable analysis, the ratio of lobar to deep CMB number was positively correlated with global (p = 0.028) and occipital (p = 0.031) amyloid burden. In primary ICH, patients with lobar and mixed CMB types are associated with increased amyloid burden than patients with deep type. The ratio of lobar to deep CMB number is an independent indicator of cerebral β-amyloid deposition.
脑微出血（CMB）的潜在病理学具有混合的皮质和深部分布，这仍然存在争议。本研究的目的是将 CMB 分布与原发性脑出血（ICH）患者的β-淀粉样蛋白负担相关联。47 例 ICH 患者接受了磁共振磁化率加权成像和 C-Pittsburgh 复合 B 正电子发射断层扫描。淀粉样蛋白负担用小脑的标准化摄取比值表示，并以中位数（四分位间距）表示。患者被分为皮质、混合（皮质和深部区域）和深部 CMB 类型。比较皮质（17%）、混合（59.6%）和深部（23.4%）CMB 类型，混合类型的总体淀粉样蛋白负担明显高于深部类型（1.10[1.03-1.25]比 1.00[0.97-1.09]，p=0.011），但低于皮质类型（1.48[1.18-1.50]，p=0.048）。多变量分析显示，皮质和深部 CMB 数量的比值与总（p=0.028）和枕部（p=0.031）淀粉样蛋白负担呈正相关。在原发性 ICH 中，具有皮质和混合 CMB 类型的患者比具有深部类型的患者具有更高的淀粉样蛋白负担。皮质和深部 CMB 数量的比值是脑β-淀粉样蛋白沉积的独立指标。
