Weingarten K, Filippi C, Barbut D, Zimmerman R D
Department of Radiology, New York Hospital-Cornell Medical Center, New York 10021, USA.
Clin Imaging. 1997 Jan-Feb;21(1):6-12. doi: 10.1016/0899-7071(95)00044-5.
The purpose of our study was to define the neuroimaging features of the cardiolipin antibody syndrome. Thirty-eight patients with elevated anticardiolipin antibody titers were studied with magnetic resonance imaging or computed tomography or both. Two patients underwent cerebral angiography. All patients had recurrent transient ischemic attacks, amaurosis, or strokes. One patient had normal imaging findings. The remaining patients had a combination of infarction and atrophy. Focal infarcts, the most common finding, were seen in 32 patients. Cerebral atrophy was seen in 26 patients and was the only radiographic finding in 5. Angiography demonstrated dramatic abnormalities in the distal portions of the anterior and posterior circulations, with multiple stenosis and occlusions and extensive pial and transdural collateral networks. The cardiolipin antibody syndrome should be suspected in young patients with transient ischemic attacks or strokes in the absence of the usual risk factors for cerebrovascular disease. The presence of raised anticardiolipin antibody titers or the cardiolipin antibody syndrome in patients with lupus, in those with other connective tissue diseases, and in patients without overt manifestations of an autoimmune disorder should be viewed as a risk factor for future ischemic cerebrovascular events. Further understanding of the precise role of these antibodies in the pathogenesis of vascular thrombosis may lead to a better understanding of the mechanisms underlying certain forms of stroke.
我们研究的目的是明确心磷脂抗体综合征的神经影像学特征。对38例抗心磷脂抗体滴度升高的患者进行了磁共振成像或计算机断层扫描，或两者均进行了检查。2例患者接受了脑血管造影。所有患者均有复发性短暂性脑缺血发作、黑矇或中风。1例患者影像学检查结果正常。其余患者有梗死和萎缩的组合表现。局灶性梗死是最常见的表现，见于32例患者。26例患者出现脑萎缩，其中5例患者脑萎缩是唯一的影像学表现。血管造影显示前循环和后循环远端有显著异常，有多处狭窄和闭塞以及广泛的软脑膜和经硬膜侧支网络。对于无常见脑血管疾病危险因素却发生短暂性脑缺血发作或中风的年轻患者，应怀疑有心磷脂抗体综合征。狼疮患者、其他结缔组织病患者以及无自身免疫性疾病明显表现的患者中，抗心磷脂抗体滴度升高或存在心磷脂抗体综合征应被视为未来缺血性脑血管事件的危险因素。进一步了解这些抗体在血管血栓形成发病机制中的精确作用，可能有助于更好地理解某些类型中风的潜在机制。
