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脑白质磁共振可见腔隙与阿尔茨海默病相关认知障碍患者脑内淀粉样蛋白沉积相关。

MRI-Visible Perivascular Spaces in the Centrum Semiovale Are Associated with Brain Amyloid Deposition in Patients with Alzheimer Disease-Related Cognitive Impairment.

机构信息

From the Department of Nuclear Medicine (H.J.K., Y.H.R.).

Department of Nuclear Medicine (H.J.K.), Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, South Korea.

出版信息

AJNR Am J Neuroradiol. 2021 Jul;42(7):1231-1238. doi: 10.3174/ajnr.A7155. Epub 2021 May 13.

Abstract

BACKGROUND AND PURPOSE

The association of perivascular spaces in the centrum semiovale with amyloid accumulation among patients with Alzheimer disease-related cognitive impairment is unknown. We evaluated this association in patients with Alzheimer disease-related cognitive impairment and β-amyloid deposition, assessed with [F] florbetaben PET/CT.

MATERIALS AND METHODS

MR imaging and [F] florbetaben PET/CT images of 144 patients with Alzheimer disease-related cognitive impairment were retrospectively evaluated. MR imaging-visible perivascular spaces were rated on a 4-point visual scale: a score of ≥3 or <3 indicated a high or low degree of MR imaging-visible perivascular spaces, respectively. Amyloid deposition was evaluated using the brain β-amyloid plaque load scoring system.

RESULTS

Compared with patients negative for β-amyloid, those positive for it were older and more likely to have lower cognitive function, a diagnosis of Alzheimer disease, white matter hyperintensity, the ε4 allele, and a high degree of MR imaging-visible perivascular spaces in the centrum semiovale. Multivariable analysis, adjusted for age and status, revealed that a high degree of MR imaging-visible perivascular spaces in the centrum semiovale was independently associated with β-amyloid positivity (odds ratio, 2.307; 95% CI, 1.036-5.136; = .041).

CONCLUSIONS

A high degree of MR imaging-visible perivascular spaces in the centrum semiovale independently predicted β-amyloid positivity in patients with Alzheimer disease-related cognitive impairment. Thus, MR imaging-visible perivascular spaces in the centrum semiovale are associated with amyloid pathology of the brain and could be an indirect imaging marker of amyloid burden in patients with Alzheimer disease-related cognitive impairment.

摘要

背景与目的

脑白质半卵圆中心血管周围间隙与阿尔茨海默病相关认知障碍患者的淀粉样蛋白沉积之间的关系尚不清楚。我们评估了与阿尔茨海默病相关认知障碍和β-淀粉样蛋白沉积的患者之间的这种关系,这些患者通过[F]氟比苯 PET/CT 进行评估。

材料与方法

回顾性评估了 144 例阿尔茨海默病相关认知障碍患者的磁共振成像和[F]氟比苯 PET/CT 图像。采用 4 分视觉量表对磁共振成像可见的血管周围间隙进行评分:评分≥3 或<3 分别表示磁共振成像可见血管周围间隙程度较高或较低。采用脑β-淀粉样斑块负荷评分系统评估淀粉样蛋白沉积。

结果

与β-淀粉样蛋白阴性的患者相比,阳性患者年龄更大,认知功能更差,阿尔茨海默病诊断,脑白质高信号,ε4 等位基因和脑白质半卵圆中心高程度的磁共振成像可见血管周围间隙。多变量分析,调整年龄和状态后,脑白质半卵圆中心高程度的磁共振成像可见血管周围间隙与β-淀粉样蛋白阳性独立相关(优势比,2.307;95%CI,1.036-5.136;=0.041)。

结论

脑白质半卵圆中心高程度的磁共振成像可见血管周围间隙独立预测了阿尔茨海默病相关认知障碍患者的β-淀粉样蛋白阳性。因此,脑白质半卵圆中心的磁共振成像可见血管周围间隙与脑淀粉样蛋白病理学相关,并且可能是阿尔茨海默病相关认知障碍患者淀粉样蛋白负荷的间接成像标志物。

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Perivascular spaces in the brain: anatomy, physiology and pathology.脑内血管周围间隙:解剖、生理与病理。
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