From the Taub Institute for Research on Alzheimer's Disease and the Aging Brain (A.L.H., K.C.I., J.M.C., A.M.B.).
Department of Neurology (J.G., A.M.B.), College of Physicians and Surgeons, Columbia University, New York, New York.
AJNR Am J Neuroradiol. 2019 Oct;40(10):1712-1718. doi: 10.3174/ajnr.A6213. Epub 2019 Sep 12.
White matter hyperintensities on T2-weighted MR imaging are typical in older adults and have been linked to several poor health outcomes, including cognitive impairment and Alzheimer disease. The presence and severity of white matter hyperintensities have traditionally been attributed to occlusive arteriopathy, but recent evidence also implicates deep medullary venule collagenosis and associated vasogenic edema. Historically, postmortem analyses have been the sole way to analyze cerebral veins, but SWI can be now used to examine cortical veins in vivo. The aim of the current study was to determine whether there is an association between the diameters of the large draining cerebral veins/sinuses and white matter hyperintensity volume.
T2-weighted FLAIR and SWI were performed in 682 older adults without dementia (mean age, 73.9 ± 5.9 years; 59.1% women). Total and regional white matter hyperintensity volume was derived. We measured the diameters of 5 regions of the cerebral venous draining system: internal cerebral veins, basal veins of Rosenthal, superior sagittal sinus, vein of Galen, and straight sinus terminus.
Increased diameter of the internal cerebral veins was associated with greater total white matter hyperintensity volume (β = 0.09, = .02) and regionally in the parietal (β = 0.10, = .006), frontal (β = 0.09, = .02), and temporal (β = 0.09, = .02) lobes. Increased diameter of the basal veins of Rosenthal was associated with greater total (β = 0.10, = .01), frontal (β = 0.11, = .003), and temporal (β = 0.09, = .02) white matter hyperintensity volume.
Our results suggest that the caliber of the internal cerebral veins and of the basal veins of Rosenthal relates to regional white matter disease.
T2 加权磁共振成像上的脑白质高信号是老年人的典型表现，与多种健康不良结局有关，包括认知障碍和阿尔茨海默病。脑白质高信号的存在和严重程度传统上归因于闭塞性小血管病，但最近的证据也提示与深部髓质小静脉胶原病和相关的血管源性水肿有关。历史上，只有尸检分析才能分析脑静脉，但现在可以使用 SWI 活体检查皮质静脉。本研究旨在确定大引流脑静脉/窦的直径与脑白质高信号体积之间是否存在关联。
对 682 名无痴呆的老年人（平均年龄 73.9±5.9 岁，59.1%为女性）进行 T2 加权 FLAIR 和 SWI 检查。得出总脑白质高信号体积和区域脑白质高信号体积。我们测量了脑静脉引流系统 5 个区域的直径：大脑内静脉、Rosenthal 基底静脉、上矢状窦、Galen 静脉和直窦终末。
大脑内静脉直径增加与总脑白质高信号体积增加相关（β=0.09， =.02），与顶叶（β=0.10， =.006）、额叶（β=0.09， =.02）和颞叶（β=0.09， =.02）区域也相关。Rosenthal 基底静脉直径增加与总脑白质高信号体积增加相关（β=0.10， =.01），与额叶（β=0.11， =.003）和颞叶（β=0.09， =.02）区域也相关。
我们的结果表明，大脑内静脉和 Rosenthal 基底静脉的口径与局部脑白质疾病有关。
