Chrostowski Jakub, Majos Marcin, Walczak Andrzej, Wachowski Mariusz, Majos Agata
Department of Radiological and Isotopic Diagnosis and Therapy, Medical University of Lodz, Poland.
Department of Radiology and Diagnostic Imaging, Medical University of Lodz, Poland.
Pol J Radiol. 2021 Sep 27;86:e564-e573. doi: 10.5114/pjr.2021.110650. eCollection 2021.
To assess the prevalence of the neuroradiological indices of cerebral small vessel disease (CSVD) in patients with severe aortic valve stenosis (AS) in magnetic resonance imaging (MRI).
34 patients (age 60-90 years, 17 women and 17 men) with severe AS and 50 healthy controls (age 61-85 years, 29 women and 21 men) underwent MRI brain examinations, which were analysed for the neuroradiological indices of CSVD: hyperintensities in periventricular white matter (PVWM) and deep white matter (DWM), enlarged perivascular spaces (ePVS), lacunar strokes, and cerebral microbleeds (CMBs).
PVWM hyperintensities were found in 46% of volunteers and was significantly lower ( = 0.027), corresponding to AS patients (80%), the density of lesions was higher in the AS group than in controls ( = 0.019). DWM hyperintensities were found more often in AS patients (76%) than in controls (66%) ( = 0.303), but the densities were similar in both groups. Lacunar strokes were found in 35% of AS patients and 16% of controls ( = 0.042). The average number of lacunar strokes per person was 0.9 in the AS group and 0.3 in the controls ( = 0.035). The AS group showed higher variance in the number of strokes: SD = 1.96 vs. SD = 1.06 in controls. Both prevalence and density of the ePVS and CMBs did not differ significantly between the groups.
Neuroradiological indices of the vascular disease do not provide an unequivocal clue to the pathogenesis of CSVD in patients with severe AS. Most observations imply that CSVD is primarily a consequence of cerebral hypoperfusion caused by AS.
通过磁共振成像（MRI）评估重度主动脉瓣狭窄（AS）患者脑小血管病（CSVD）的神经放射学指标的患病率。
34例重度AS患者（年龄60 - 90岁，女性17例，男性17例）和50例健康对照者（年龄61 - 85岁，女性29例，男性21例）接受了脑部MRI检查，分析其CSVD的神经放射学指标：脑室周围白质（PVWM）和深部白质（DWM）高信号、血管周围间隙增宽（ePVS）、腔隙性脑梗死和脑微出血（CMB）。
46%的志愿者存在PVWM高信号，显著低于AS患者（80%）（P = 0.027），AS组病变密度高于对照组（P = 0.019）。AS患者中DWM高信号的发生率（76%）高于对照组（66%）（P = 0.303），但两组密度相似。35%的AS患者和16%的对照组发现有腔隙性脑梗死（P = 0.042）。AS组人均腔隙性脑梗死数量为0.9，对照组为0.3（P = 0.035）。AS组脑梗死数量的方差更高：标准差为1.96，而对照组为1.06。两组间ePVS和CMB的患病率及密度均无显著差异。
血管疾病的神经放射学指标并不能明确提示重度AS患者CSVD的发病机制。大多数观察结果表明，CSVD主要是AS导致脑灌注不足的结果。
