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不同程度颅内和颅外动脉粥样硬化的无卒中患者的血管周围间隙及脑CT灌注的临床特征

Clinical characteristics of perivascular space and brain CT perfusion in stroke-free patients with intracranial and extracranial atherosclerosis of different extents.

作者信息

Wang Hui, Nie Zhi-Yu, Liu Meng, Li Ren-Ren, Huang Li-He, Lu Zheng, Jin Ling-Jing, Li Yun-Xia

机构信息

Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200065, China.

Tinglin Hospital of Jinshan District of Shanghai, Shanghai 201505, China.

出版信息

Ann Transl Med. 2020 Mar;8(5):215. doi: 10.21037/atm.2020.01.35.

Abstract

BACKGROUND

This study aimed to investigate the clinical characteristics of perivascular space (PVS) and cerebral blood flow (CBF) in stroke-free patients with intracranial and extracranial atherosclerosis of different extents.

METHODS

Two hundred and twenty-two patients received carotid artery ultrasonography, magnetic resonance imaging (MRI), cranial computed tomography angiography (CTA) and computed tomography perfusion (CTP). PVS was scored. The extents of intracranial and extracranial arteriosclerosis were evaluated based on the scores of intracranial and extracranial arteriosclerosis. CTP was done to determine the CBF in the region of interest (ROI). The risk factors of vascular disease were assessed in patients with and without PVS. The relationship between PVS and CBF was evaluated among patients with different scores of intracranial and extracranial atherosclerosis.

RESULTS

The incidences of intracranial atherosclerosis and extracranial carotid plaque were higher in PVS patients. Subjects with intracranial and/or extracranial arteriosclerosis also had a higher incidence of PVS as compared to controls. The score of intracranial and/or extracranial arteriosclerosis was positively related to the score of basal ganglia PVS. Patients with intracranial and/or extracranial arteriosclerosis had lower CBF as compared to controls. The CBF was negatively associated with the intracranial and/or extracranial arteriosclerosis and the PVS score.

CONCLUSIONS

The incidence of PVS in patients with intracranial and extracranial arteriosclerosis is higher than in patients without arteriosclerosis. The extent of intracranial and extracranial atherosclerosis is related to PVS, especially the basal ganglia PVS. The decreased CBF may be associated with the occurrence of PVS.

摘要

背景

本研究旨在调查不同程度颅内和颅外动脉粥样硬化的无卒中患者的血管周围间隙(PVS)和脑血流量(CBF)的临床特征。

方法

222例患者接受了颈动脉超声、磁共振成像(MRI)、头颅计算机断层血管造影(CTA)和计算机断层灌注(CTP)检查。对PVS进行评分。根据颅内和颅外动脉硬化的评分评估颅内和颅外动脉硬化的程度。进行CTP以确定感兴趣区域(ROI)的CBF。对有和无PVS的患者评估血管疾病的危险因素。在不同颅内和颅外动脉粥样硬化评分的患者中评估PVS与CBF之间的关系。

结果

PVS患者的颅内动脉粥样硬化和颅外颈动脉斑块的发生率较高。与对照组相比,有颅内和/或颅外动脉硬化的受试者的PVS发生率也较高。颅内和/或颅外动脉硬化评分与基底节PVS评分呈正相关。与对照组相比,有颅内和/或颅外动脉硬化的患者的CBF较低。CBF与颅内和/或颅外动脉硬化及PVS评分呈负相关。

结论

颅内和颅外动脉硬化患者的PVS发生率高于无动脉硬化患者。颅内和颅外动脉粥样硬化的程度与PVS有关,尤其是基底节PVS。CBF降低可能与PVS的发生有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/517a/7154435/d411209257e6/atm-08-05-215-f1.jpg

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