From the Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, United Kingdom (D.J.T., A.J.L., H.S.M.)
Neuroscience Research Centre, Molecular and Clinical Sciences Research Institute, St. George's, University of London, United Kingdom (E.Z., T.R.B.).
Stroke. 2018 Jul;49(7):1656-1661. doi: 10.1161/STROKEAHA.117.019970. Epub 2018 Jun 4.
Magnetic resonance imaging may be useful to assess disease severity in cerebral small vessel disease (SVD), identify those individuals who are most likely to progress to dementia, monitor disease progression, and act as surrogate markers to test new therapies. Texture analysis extracts information on the relationship between signal intensities of neighboring voxels. A potential advantage over techniques, such as diffusion tensor imaging, is that it can be used on clinically obtained magnetic resonance sequences. We determined whether texture parameters (TP) were abnormal in SVD, correlated with cognitive impairment, predicted cognitive decline, or conversion to dementia.
In the prospective SCANS study (St George's Cognition and Neuroimaging in Stroke), we assessed TP in 121 individuals with symptomatic SVD at baseline, 99 of whom attended annual cognitive testing for 5 years. Conversion to dementia was recorded for all subjects during the 5-year period. Texture analysis was performed on fluid-attenuated inversion recovery and T1-weighted images. The TP obtained from the SVD cohort were cross-sectionally compared with 54 age-matched controls scanned on the same magnetic resonance imaging system.
There were highly significant differences in several TP between SVD cases and controls. Within the SVD population, TP were highly correlated to other magnetic resonance imaging parameters (brain volume, white matter lesion volume, lacune count). TP correlated with executive function and global function at baseline and predicted conversion to dementia, after controlling for age, sex, premorbid intelligence quotient, and magnetic resonance parameters.
TP, which can be obtained from routine clinical images, are abnormal in SVD, and the degree of abnormality correlates with executive dysfunction and global cognition at baseline and decline during 5 years. TP may be useful to assess disease severity in clinically collected data. This needs testing in data clinically acquired across multiple sites.
磁共振成像（MRI）可用于评估脑小血管病（SVD）的严重程度，识别最有可能发展为痴呆的患者，监测疾病进展，并作为替代标志物来测试新疗法。纹理分析提取了相邻体素之间信号强度关系的信息。与弥散张量成像（DTI）等技术相比，它的一个潜在优势是可以用于临床获得的磁共振序列。我们确定 SVD 患者的纹理参数（TP）是否异常，与认知障碍相关，预测认知下降或转化为痴呆。
在前瞻性 SCANS 研究（圣乔治中风认知和神经影像学研究）中，我们在基线时评估了 121 例有症状 SVD 患者的 TP，其中 99 例在 5 年内每年接受认知测试。在 5 年内记录了所有受试者向痴呆的转化。在液体衰减反转恢复和 T1 加权图像上进行纹理分析。从 SVD 队列中获得的 TP 与在同一磁共振成像系统上扫描的 54 名年龄匹配的对照者进行了横断面比较。
SVD 病例与对照组之间存在几个 TP 的高度显著差异。在 SVD 人群中，TP 与其他磁共振成像参数（脑体积、白质病变体积、腔隙计数）高度相关。TP 在基线时与执行功能和总体功能相关，并在控制年龄、性别、发病前智商和磁共振参数后预测向痴呆的转化。
可以从常规临床图像中获得的 TP 在 SVD 中异常，异常程度与基线时的执行功能障碍和总体认知以及 5 年内的下降相关。TP 可能有助于评估临床收集数据中的疾病严重程度。这需要在跨多个站点临床获得的数据中进行测试。
