脑血管病患者脑微出血磁共振成像筛查及相关因素的分析

MR-image screening of cerebral microbleeds and analysis of related factors in cerebrovascular disease patients

目的对临床疑似脑血管病的患者进行脑微出血（cerebral microbleeds，CMBs）病变的磁共振筛查，探讨CMBs程度与高血压严重程度和脑白质改变的关系。方法连续对447倒疑似脑血管病患者应用梯度回波T2^＊序列检查，依据有无CMBs，将患者分为CMBs组（95例）和无CMBs组（352例）。记录CMBs数量、部位、脑白质改变程度及其血压水平．并进行相关分析。结果CMBs发生率21．25％。CMBs组患者的年龄、高血压、皮质下动脉硬化性脑病影像改变、大脑白质病变与无CMBs组比较，差异有统计学意义（P〈0．01）；CMBs组患者病灶分布于脑叶（42．09％）、丘脑（19．77％）、脑干（14．41％）、小脑（11．58％）、侧脑室旁（6．21％）和基底节（5．65％）。logistic回归分析显示，CMBs发生的相关因素有高血压（OR=2．208，P〈0．01）、年龄（OR=2．082，P〈0．01）。CMBs分级与高血压严重程度及脑白质改变的严重程度呈正相关（r=0．224．r=0．376，P〈0．001）。结论脑血管病患者CMBs发生率较高，CMBs与高血压严重程度、脑白质改变程度有明显的相关性。

Objectives To screen CMBs with MRI in patients with suspected cerebral vascular diseases,and explore the relations between CMBs degree and the hypertension severity degree and brain white matter changes. Methods 447 consecutive patients with suspected cerebral vascular disease were examined with T2^＊ -GRE sequence to detect CMBs lesions. The number and location of mierobleed lesions,white matter changes and blood pressure levels were recorded. According to whether there were CMBs,the patients were divided into two groups,CMBs group（95 cases） and non-CMBs group（352 cases）. Results The loci in patienis of CMBs group were in the lobes of brain（42.09 % ） ,the thalami （ 19.77% ）, brainstem （ 14.41 %）, cerebellum（11.58%）, periventricular area（6.21 % ） and basal ganglia（5.65 % ）. Compared with non-CMBs group, The age, hypertension,Binswanger image changes and the white matter lesions in the patients with CMBs had statistically significant difference. Logistic regression analysis indicated that the occurrence of CMBs was related to the factors such as hypertension and age. The severity of CMBs was positively correlated with the severity of hypertension and cerebral white matter changes. Conclusions The incidence of CMBs in patients with cerebrovascular disease is high. The severity of CMBs is positively correlated with the severity of hypertension and cerebral white matter changes.