Manolio T A, Kronmal R A, Burke G L, Poirier V, O'Leary D H, Gardin J M, Fried L P, Steinberg E P, Bryan R N
Division of Epidemiology and Clinical Applications, National Heart, Lung and Blood Institute, Bethesda, MD 20892.
Stroke. 1994 Feb;25(2):318-27. doi: 10.1161/01.str.25.2.318.
Cerebral magnetic resonance imaging often detects abnormalities whose significance is unknown. The prevalence and correlates of findings such as ventricular enlargement, sulcal widening, and increased white matter signal intensity were examined in 303 men and women aged 65 to 95 years participating in a multicenter study of cardiovascular disease.
Cerebral magnetic resonance imaging was performed and interpreted according to a standard protocol, and findings were correlated with measures of cardiovascular disease and its risk factors.
Measures of cerebral atrophy increased with age and were greater in men than in women (each P < .01). Ventricular enlargement and sulcal widening were associated with prior stroke, hypertension, diabetes, and white race (each P < .03). Extent of white matter hyperintensity was associated with age, prior stroke, hypertension, and use of diuretics (each P < .004). On multivariate analysis, age, male gender, white race, and prior stroke retained strong associations with increased ventricular and sulcal scores. After adjustment for age, prior stroke, and other risk factors, white matter hyperintensity was associated with atherosclerosis as measured by increased internal carotid artery thickness on ultrasound.
Cerebral atrophy and white matter hyperintensity are common in the elderly and are associated with age, prior stroke, and known cardiovascular risk factors. Though these findings have been suggested to represent normal aging, their wide variability and associations with cardiovascular disease argue against their inevitability with advancing age and support the need to identify modifiable risk factors for these abnormalities.
脑磁共振成像常检测到一些意义不明的异常情况。在一项心血管疾病多中心研究中，对303名年龄在65至95岁的男性和女性进行了检查，以探究诸如脑室扩大、脑沟增宽和白质信号强度增加等表现的患病率及其相关因素。
按照标准方案进行脑磁共振成像检查并解读结果，将这些发现与心血管疾病及其危险因素的测量指标进行关联分析。
脑萎缩的测量指标随年龄增长而增加，男性高于女性（均P <.01）。脑室扩大和脑沟增宽与既往中风、高血压、糖尿病和白种人相关（均P <.03）。白质高信号的程度与年龄、既往中风、高血压及利尿剂的使用相关（均P <.004）。多因素分析显示，年龄、男性性别、白种人和既往中风与脑室和脑沟评分增加仍有密切关联。在对年龄、既往中风及其他危险因素进行校正后，白质高信号与超声测量的颈内动脉厚度增加所反映的动脉粥样硬化相关。
脑萎缩和白质高信号在老年人中很常见，且与年龄、既往中风及已知的心血管危险因素相关。尽管这些发现被认为代表正常衰老，但它们的广泛变异性以及与心血管疾病的关联表明，它们并非随着年龄增长而必然出现，这支持了需要识别这些异常情况的可改变危险因素。
