Zhang Ruiting, Zhou Ying, Yan Shenqiang, Zhong Genlong, Liu Chang, Jiaerken Yerfan, Song Ruirui, Yu Xinfeng, Zhang Minming, Lou Min
Department of Neurology, The Second Affiliated Hospital of Zhejiang University, School of MedicineHangzhou, China.
Department of Radiology, The Second Affiliated Hospital of Zhejiang University, School of MedicineHangzhou, China.
Front Aging Neurosci. 2017 Aug 8;9:269. doi: 10.3389/fnagi.2017.00269. eCollection 2017.
Cerebral venous collagenosis played a role in the pathogenesis of white matter hyperintensities (WMHs) through venous ischemia. Since pathological changes of veins from intramural stenosis to luminal occlusion is a dynamic process, we aimed to create a deep medullary veins (DMVs) visual grade on susceptibility-weighted images (SWI) and explore the relationship of DMVs and WMHs based on venous drainage regions. We reviewed clinical, laboratory and imaging data from 268 consecutive WMHs patients and 20 controls. SWI images were used to observe characteristics of DMVs and a brain region-based DMVs visual score was given by two experienced neuroradiologists. Fluid attenuated inversion recovery (FLAIR) images were used to calculate WMHs volume. Logistic-regression analysis and partial Pearson's correlation analysis were used to examine the association between the DMVs score and WMHs volume. We found that the DMVs score was significantly higher in WMHs patients than in controls ( < 0.001). Increased DMVs score was independently associated with higher WMHs volume after adjusting for total cholesterol level and number of lacunes ( < 0.001). Particularly, DMVs scores were correlated with regional PVHs volumes in the same brain region most. The newly proposed DMVs grading method allows the clinician to monitor the course of DMVs disruption. Our findings of cerebral venous insufficiency in WMHs patients may help to elucidate the pathogenic mechanisms and progression of WMHs.
脑静脉胶原化通过静脉缺血在白质高信号（WMHs）的发病机制中起作用。由于静脉从壁内狭窄到管腔闭塞的病理变化是一个动态过程，我们旨在在磁敏感加权成像（SWI）上创建深部髓静脉（DMVs）视觉分级，并基于静脉引流区域探索DMVs与WMHs之间的关系。我们回顾了268例连续性WMHs患者和20例对照的临床、实验室和影像学数据。使用SWI图像观察DMVs的特征，并由两名经验丰富的神经放射科医生给出基于脑区的DMVs视觉评分。使用液体衰减反转恢复（FLAIR）图像计算WMHs体积。采用逻辑回归分析和偏Pearson相关分析来检验DMVs评分与WMHs体积之间的关联。我们发现，WMHs患者的DMVs评分显著高于对照组（<0.001）。在校正总胆固醇水平和腔隙数量后，DMVs评分增加与更高的WMHs体积独立相关（<0.001）。特别是，DMVs评分与同一脑区的区域脑白质疏松（PVHs）体积相关性最强。新提出的DMVs分级方法使临床医生能够监测DMVs破坏的过程。我们在WMHs患者中发现的脑静脉功能不全可能有助于阐明WMHs的致病机制和进展。
