Adachi T, Takagi M, Hoshino H, Inafuku T
Third Division of Internal Medicine, Shimane Medical University, Izumo, Japan.
Stroke. 1997 Nov;28(11):2174-9. doi: 10.1161/01.str.28.11.2174.
The pathogenesis of periventricular hyperintensity (PVH) is still uncertain. We investigated the relationship between PVH and risk factors for cerebrovascular diseases, especially extracranial carotid artery stenosis (ECAS).
We studied PVH and ECAS in 323 subjects between 1991 and 1994. Using 1.5-T MRI scan images, we measured PVH quantitatively at eight points and evaluated cerebral infarction. Duplex carotid sonography was performed on the carotid arteries bilaterally and used to divide the severity of ECAS into five grades. Risk factors for cerebrovascular diseases and atherosclerotic complications were assessed from the clinical history.
Age was significantly correlated with the size of frontal and whole PVH (P < .01). Frontal PVH was significantly more severe in subjects with hypertension (P < .05). Frontal, occipital, and whole PVH were significantly more severe in subjects with a history of cerebrovascular accident (P < .01). Other risk factors and atherosclerotic complications were not correlated with PVH. There were no significant differences in the severity of PVH among the five groups of ECAS. The severity of PVH in each region was not related to ECAS. There was no significant difference in the age of patients in relation to the five grades of ECAS. However, PVH was significantly more severe in subjects with lacunar infarction or infarction of the deep border zone (P < .05). There was no relationship between PVH and cortical infarction or infarction of the cortical border zone.
PVH correlated with age, hypertension, and past history of cerebrovascular disease but not with ECAS. PVH was significantly more severe in lacunar infarction and infarction of the deep border zone. These results suggest that small-vessel disease may underlie the pathogenesis and development of PVH.
脑室周围白质高信号（PVH）的发病机制仍不明确。我们研究了PVH与脑血管疾病危险因素之间的关系，尤其是颅外颈动脉狭窄（ECAS）。
我们在1991年至1994年间对323名受试者进行了PVH和ECAS研究。使用1.5-T磁共振成像扫描图像，我们在八个点对PVH进行了定量测量，并评估了脑梗死情况。对双侧颈动脉进行双功能超声检查，用于将ECAS的严重程度分为五个等级。从临床病史中评估脑血管疾病和动脉粥样硬化并发症的危险因素。
年龄与额叶和全脑PVH的大小显著相关（P <.01）。高血压患者的额叶PVH明显更严重（P <.05）。有脑血管意外病史的患者，额叶、枕叶和全脑PVH明显更严重（P <.01）。其他危险因素和动脉粥样硬化并发症与PVH无关。五组ECAS患者的PVH严重程度无显著差异。每个区域的PVH严重程度与ECAS无关。与ECAS的五个等级相关的患者年龄无显著差异。然而，腔隙性梗死或深部边界区梗死患者的PVH明显更严重（P <.05）。PVH与皮质梗死或皮质边界区梗死之间无关联。
PVH与年龄、高血压和脑血管疾病既往史相关，但与ECAS无关。腔隙性梗死和深部边界区梗死患者的PVH明显更严重。这些结果表明，小血管疾病可能是PVH发病机制和发展的基础。
