治疗脑小血管病的新见解：与深部髓静脉的关联
New Insights in Addressing Cerebral Small Vessel Disease: Association With the Deep Medullary Veins.
作者信息
Xu Zhihua, Li Fangfei, Wang Bing, Xing Dengxiang, Pei Yusong, Yang Benqiang, Duan Yang
机构信息
Department of Radiology, TongDe Hospital of Zhejiang Province, Hangzhou, China.
Department of Radiology, Center for Neuroimaging, General Hospital of Northern Theater Command, Shenyang, China.
出版信息
Front Aging Neurosci. 2020 Dec 1;12:597799. doi: 10.3389/fnagi.2020.597799. eCollection 2020.
OBJECTIVE
To assess the suitability of deep medullary vein visibility in susceptibility weighted imaging-magnetic resonance imaging studies as a method for the diagnosis and evaluation of cerebral small vessel disease progression.
METHODS
A total of 92 patients with CSVD were enrolled and baseline clinical and imaging data were reviewed retrospectively. Neuroimaging biomarkers of CSVD including high-grade white matter hyperintensity (HWMH), cerebral microbleed (CMB), enlarged perivascular space (PVS), and lacunar infarct (LI) were identified and CSVD burden was calculated. Cases were grouped accordingly as mild, moderate, or severe. The DMV was divided into six segments according to the regional anatomy. The total DMV score (0-18) was calculated as the sum of the six individual segmental scores, which ranged from 0 to 3, for a semi-quantitative assessment of the DMV based on segmental continuity and visibility.
RESULTS
The DMV score was independently associated with the presence of HWMH, PVS, and LI ( < 0.05), but not with presence and absence of CMB ( > 0.05). Correlation between the DMV score and the CSVD burden was significant ( < 0.05) [OR 95% C.I., 1.227 (1.096-1.388)].
CONCLUSION
The DMV score was associated with the presence and severity of CSVD.
目的
评估在磁共振成像敏感性加权成像研究中脑深髓静脉显影作为诊断和评估脑小血管病进展方法的适用性。
方法
共纳入92例脑小血管病患者，回顾性分析其基线临床和影像学资料。确定脑小血管病的神经影像学生物标志物，包括高级别白质高信号（HWMH）、脑微出血（CMB）、血管周围间隙增宽（PVS）和腔隙性梗死（LI），并计算脑小血管病负担。病例据此分为轻度、中度或重度。根据局部解剖结构将脑深髓静脉分为六个节段。计算脑深髓静脉总分（0 - 18分），即六个节段分数之和，每个节段分数范围为0至3分，基于节段连续性和显影情况对脑深髓静脉进行半定量评估。
结果
脑深髓静脉分数与HWMH、PVS和LI的存在独立相关（<0.05），但与CMB的有无无关（>0.05）。脑深髓静脉分数与脑小血管病负担之间存在显著相关性（<0.05）[比值比95%置信区间，1.227（1.096 - 1.388）]。
结论
脑深髓静脉分数与脑小血管病的存在及严重程度相关。
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