摘要
目的:探究脑白质高信号(WMH)及其半暗带(WMH-P)的病理生理机制是否涉及间质液体含量的改变、是否存在病理级联反应.方法:对78例非痴呆型脑小血管病(CSVD)患者行3.0T MRI扫描,包括T1WI、FLAIR、扩散峰度成像(DKI)序列,测定深部和脑室旁WMH、WMH周围正常白质(NAWM)掩膜层最内层到最外层(NAWM-L1至NAWM-L15)及全脑NAWM区域DKI各参数值,通过确定DKI各参数指标的 WMH-P范围,比较 WMH及其 WMH-P内DKI的扩散率与扩散峰度值异常的范围、探究其内DKI各参数值间的关系,评估WMH及其 WMH-P内间质液体含量的差异及不同微结构组织间的关系.结果:DKI中各参数AD、MD、RD、AK、MK、RK、FA指标界定的 WMH-P范围分别为 NAWM-L9、NAWM-L6、NAWM-L5、NAWM-L6、NAWM-L3、NAWM-L3、NAWM-L3.WMH至NAWM-L9外缘的区域内DKI各参数指标间均存在相关性,其中MD与RD值的相关性最强(r=-0.989,P＜0.01).而 AD、AK、MD、RD、FA 值分别与 MK 值(r=-0.703;0.653;-0.802;-0.818;0.744;P 均＜0.01)、RK 值(r=-0.523;0.364;-0.656;-0.692;P 均＜0.01)仅在 WMH 及其WMH-P内存在相关性;AD值与FA值(r=-0.527,P＜0.01)仅在 WMH及其 WMH-P内存在相关性.结论:WMH-P扩散率异常的范围较扩散峰度值异常的范围更广,WMH及其WMH-P内DKI部分参数间存在相关性,提示WMH及其 WMH-P的病理生理机制可能涉及间质液体含量的改变,间质液体含量及不同微结构组织间可能存在病理级联反应.
Abstract
Objective:To investigate whether the pathophysiological mechanism of white matter hyperintensities(WMH)and its penumbra(WMH-P)is associated with the change of interstitial flu-id content and whether there is pathological cascade reaction.Methods:Seventy-eight patients with non-dementia cerebrovascular disease(CSVD)underwent 3.0T MRI scanning,including T1WI,FLAIR and diffusion kurtosis imaging(DKI).The DKI parameters'values of deep and periventricular WMH,the innermost layer to outermost layer of normal-appearing white matter(NAWM)mask layer(NAWM-L1 to NAWM-L15),and the whole brain NAWM region were measured.By determining the WMH-P range of each DKI parameter,the abnormal range of diffusivity and diffusion kurtosis values in WMH and WMH-P were compared,the relationship between the values of DKI parameters in WMH and WMH-P was explored,and the difference of liquid content in interstitial and the relationship between different microstructure were evaluated.Results:The WMH-P ranges defined by AD,MD,RD,AK,MK,RK and FA are NAWM-L9,NAWM-L6,NAWM-L5,NAWM-L6,NAWM-L3,NAWM-L3 and NAWM-L3,respectively.There were correlations among DKI parameters in the outer edge of WMH to NAWM-L9,and the correlation between MD and RD was strongest(r=-0.989,P＜0.01).The values of AD,AK,MD,RD,and FA were correlated with MK value(r=-0.703;0.653;-0.802;-0.818;0.744;P＜0.01)and RK value(r=-0.523;0.364;-0.656;-0.692;P＜0.01)was found only in WMH and WMH-P.The correlation between AD value and FA value(r=-0.527,P＜0.01)was found only in WMH and WMH-P.Conclusion:The range of WMH-P of diffusivity is wider than that of diffusion kurtosis,and there is a correlation between some DKI parameters in WMH and WMH-P.It suggested that the pathophysiological mechanism of WMH and WMH-P may be associated with the change of interstitial fluid content,and there may be pathological cascade reaction between interstitial fluid content and different microstructure.
NETL
NSTL
万方数据