脑小血管病MRI表现对痴呆的预测作用

Predictive Value of Cerebral Small Vessel Disease on Magnetic Resonance Imaging for Dementia

随着全球老龄化,痴呆发病率快速上升,而且痴呆具有不可逆性、缺乏有效治疗措施,故探索预测痴呆发生的有效指标成为关键。脑小血管病(cerebral small vessel disease,CSVD)被认为与痴呆密切相关,其颅脑磁共振成像(magnetic resonance imaging,MRI)可表现为腔隙(lacunes)、新发皮层下小梗死(recent small subcortical infarcts)、脑白质高信号(white matter hyperintensities,WMH)、扩大的血管周围间隙(enlarged perivascular spaces,EPVS)及脑微出血(cerebral microbleeds,CMB)等。本文通过综述CSVD颅脑MRI表现与痴呆相关性的研究进展,发现多发静息性或位于基底节区的腔隙性梗死(lacunar infarction,LI)或腔隙、重度WMH、多脑叶分布性脑叶微出血(lobar microbleeds,LMB),均可作为预测痴呆发生的有效指标。

Dementia has been irreversible, lack of effective treatment, and increasing rapidly as the global aging, so exploring the useful predictors of dementia became more important. Cerebral small vessel disease （CSVD） has been reported to be associated with all types of dementia. Features of CSVD seen on magnetic resonance imaging （MRI） include recent small subcortical infarcts, lacunes, white matter hyperintensities （WMH）, enlarged perivascular spaces （EPVS） and cerebral microbleeds （CMB）. This paper has reviewed the research progress of CSVD and dementia, and made a conclusion that silent multiple lacunar infarctions, lacunes or lacunar infarctions in basal ganglia, severe WMH and multiple lobar microbleeds could be the predictors of dementia.