Manolio T A, Burke G L, O'Leary D H, Evans G, Beauchamp N, Knepper L, Ward B
Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, Bethesda, MD20892-7934, USA.
Arterioscler Thromb Vasc Biol. 1999 Feb;19(2):356-65. doi: 10.1161/01.atv.19.2.356.
Cerebral magnetic resonance imaging (MRI) has demonstrated a high prevalence of infarct-like lesions, white matter hyperintensities, and evidence of cerebral atrophy in older adults. While these findings are generally believed to be related to ischemia and atherosclerosis, their relationship to atherosclerosis in the carotid arteries remains to be explored. Study subjects were part of the multicenter Cardiovascular Health Study, a cross-sectional study of 3502 women and men >/=65 years of age undergoing cranial MRI and carotid ultrasonography. MRI infarcts were detected in 1068 participants (29.3%) and measurable carotid plaque in 2745 (75.3%). MRI infarcts, ventricular and sulcal widening, and white matter score were strongly associated with carotid intimal-medial thickness (IMT) and stenosis degree after adjustment for age and sex (all P<0. 01). Associations with plaque characteristics were less strong and less consistent; MRI infarcts were weakly associated only with surface irregularity, and ventricular size was weakly associated only with lesion density (both P<0.04). In contrast, sulcal widening was strongly related to plaque characteristics, with scores being higher in those with heterogeneous and irregular plaque (both P<0. 009). Adjustment for other risk factors, and for carotid IMT/stenosis, removed associations of MRI findings with plaque characteristics except for weak relationships remaining between MRI infarcts and surface irregularity and between sulcal score and heterogeneous plaque (both P<0.03). MRI abnormalities show strong and consistent relationships with increasing carotid IMT and stenosis degree but less strong associations with plaque characteristics, especially after adjusting for IMT and stenosis.
脑磁共振成像（MRI）显示，在老年人中，梗死样病变、白质高信号以及脑萎缩的发生率很高。虽然一般认为这些发现与缺血和动脉粥样硬化有关，但它们与颈动脉粥样硬化的关系仍有待探索。研究对象是多中心心血管健康研究的一部分，这是一项对3502名年龄≥65岁的男女进行头颅MRI和颈动脉超声检查的横断面研究。1068名参与者（29.3%）检测到MRI梗死，2745名（75.3%）检测到可测量的颈动脉斑块。在调整年龄和性别后，MRI梗死、脑室和脑沟增宽以及白质评分与颈动脉内膜中层厚度（IMT）和狭窄程度密切相关（所有P<0.01）。与斑块特征的关联则较弱且不太一致；MRI梗死仅与表面不规则性弱相关，脑室大小仅与病变密度弱相关（均P<0.04）。相比之下，脑沟增宽与斑块特征密切相关，在斑块异质性和不规则的人群中评分更高（均P<0.009）。调整其他危险因素以及颈动脉IMT/狭窄后，MRI结果与斑块特征之间的关联消失，仅MRI梗死与表面不规则性以及脑沟评分与异质性斑块之间仍存在弱关联（均P<0.03）。MRI异常与颈动脉IMT增加和狭窄程度密切且一致相关，但与斑块特征的关联较弱，尤其是在调整IMT和狭窄后。
