Nylander Ruta, Fahlström Markus, Rostrup Egill, Kullberg Joel, Damangir Soheil, Ahlström Håkan, Lind Lars, Larsson Elna-Marie
1 Department of Surgical Sciences, Radiology, Uppsala University, Sweden.
2 Functional Imaging Unit, Department of Diagnostics, Glostrup hospital, University of Copenhagen, Denmark.
Acta Radiol. 2018 May;59(5):612-618. doi: 10.1177/0284185117727567. Epub 2017 Aug 16.
Background Cerebral white matter hyperintensities (WMHs), lacunes, and microbleeds are seen on magnetic resonance imaging (MRI) in small vessel disease (SVD). Purpose To assess SVD on MRI and its evolution over five years in an elderly population and to investigate whether relative cerebral blood flow (rCBF) at baseline was related to the progression of white matter (WM) lesions. Material and Methods In a population-based study, 406 participants aged 75 years underwent morphological MRI of the brain and 252 of them again at age 80 years. At age 75 years, a perfusion scan was also done. WMHs were evaluated qualitatively (visual scoring) and quantitatively (CASCADE software). Lacunes and microbleeds were counted. Results A significant progression of the WMH score and WMH volume occurred over five years ( P < 0.0001). New lacunes were seen in 10%. Participants with new lacunes at age 80 years showed a more pronounced increase in WMHs (P < 0.0001). Microbleeds were present in 14% at age 75 years. The visual WMH score was significantly associated with the presence of microbleeds ( P < 0.0001). There was no relationship between total WM rCBF and WMH volume at age 75 years, and no significant associations between regional or total rCBF at age 75 years and changes in WMH volume over five years. The total WM and GM volume decreased significantly between the ages of 75 and 80 years ( P < 0.0001). Conclusion MRI manifestations of SVD progressed over five years in an elderly population (age range = 75-80 years). rCBF was not associated with WMH volume or progression of WMH volume.
在小血管疾病（SVD）中，磁共振成像（MRI）可显示脑白质高信号（WMHs）、腔隙和微出血。目的：评估老年人群中MRI上的SVD及其5年演变情况，并研究基线时的相对脑血流量（rCBF）是否与白质（WM）病变进展相关。材料与方法：在一项基于人群的研究中，406名75岁的参与者接受了脑部形态学MRI检查，其中252人在80岁时再次接受检查。75岁时还进行了灌注扫描。对WMHs进行定性（视觉评分）和定量（CASCADE软件）评估。统计腔隙和微出血的数量。结果：5年间WMH评分和WMH体积显著进展（P < 0.0001）。10%的参与者出现了新的腔隙。80岁时有新腔隙的参与者WMHs增加更为明显（P < 0.0001）。75岁时14%的参与者存在微出血。视觉WMH评分与微出血的存在显著相关（P < 0.0001）。75岁时总WM rCBF与WMH体积之间无相关性，75岁时局部或总rCBF与5年间WMH体积变化之间无显著关联。75岁至80岁之间总WM和灰质体积显著减少（P < 0.0001）。结论：老年人群（年龄范围 = 75 - 80岁）中SVD的MRI表现5年间有所进展。rCBF与WMH体积或WMH体积进展无关。
