脑淀粉样血管病的早期磁共振成像及随访研究
Early MRI imaging and follow-up study in cerebral amyloid angiopathy.
作者信息
Zhang Shan-Chun, Jia Jian-Jun, Zhao Heng-Li, Zhou Bo, Wang Wei, Lu Xiang-Hui, Wang Hao, Wang Zhen-Fu, Wu Wei-Ping
机构信息
Geriatric Neurological Department of the Second Medical Centre and National Clinical Research Center of Geriatric Disease, Chinese People's Liberation Army General Hospital, Beijing, 100853, China.
Geriatric Cardiological Department of the Second Medical Centre and National Clinical Research Center of Geriatric Disease, Chinese People's Liberation Army General Hospital, Beijing, 100853, China.
出版信息
Open Med (Wars). 2021 Feb 2;16(1):257-263. doi: 10.1515/med-2021-0212. eCollection 2021.
AIM
To study the imaging features of leukoaraiosis (LA) and hemorrhage in cerebral amyloid angiopathy (CAA) patients.
METHODS
The earliest MRI images of probable CAA patients and non-CAA patients were collected. The characteristics of LA in the two groups were analyzed. Cerebral micro bleeding (CMB), superficial siderosis (SS), and intracranial hemorrhage (ICH) were recorded in the follow-up study. The space relationship between CMB or SS and ICH was assessed.
RESULTS
We found that 10/21 (47.6%) patients had occipital prominent LA and 14/21 (66.7%) patients had subcortical punctate LA before the ICH, which was higher than that of the ones in the control group ( = 0.015 and 0.038, respectively). The recurrence rate of ICH was 100% (3/3) in patients with diffuse SS and 36.4% (4/11) in patients without. The recurrence rate of ICH was 60% (3/5) in patients with multiple-lobe CMBs and 44.4% (4/9) in those without. The location of the ICH and CMB was inconsistent. ICH occurred in the ipsilateral cerebral hemisphere of SS in three patients with diffuse SS.
CONCLUSION
LA, diffuse SS, and multiple-lobe CMBs are important imaging characteristics of CAA, which may help make early diagnosis and predict the recurrence of ICH.
目的
研究脑淀粉样血管病（CAA）患者脑白质疏松（LA）及出血的影像学特征。
方法
收集可能患有CAA患者和非CAA患者的最早MRI图像。分析两组患者LA的特征。在随访研究中记录脑微出血（CMB）、表面铁沉积（SS）和颅内出血（ICH）情况。评估CMB或SS与ICH之间的空间关系。
结果
我们发现，10/21（47.6%）的患者在ICH发生前有枕叶明显LA，14/21（66.7%）的患者有皮质下点状LA，这高于对照组患者（分别为P = 0.015和0.038）。弥漫性SS患者的ICH复发率为100%（3/3），无弥漫性SS患者的ICH复发率为36.4%（4/11）。多叶CMB患者的ICH复发率为60%（3/5），无多叶CMB患者的ICH复发率为44.4%（4/9）。ICH和CMB的位置不一致。3例弥漫性SS患者的ICH发生在SS同侧脑半球。
结论
LA、弥漫性SS和多叶CMB是CAA的重要影像学特征，有助于早期诊断及预测ICH的复发。
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