豆纹动脉数量与脑小血管病的相关性分析

Correlation between Number of Lenticulostriate Arteries and Cerebral Small Vessel Disease

目的:探讨豆纹动脉(LSA)数量与脑小血管病(CSVD)患者脑灌注改变的相关性,及其与CSVD严重程度之间的相关性。方法:回顾性收集接受头颅数字减影血管造影(DSA)检查的594例患者的相关资料。DSA观察LSA数量,CTP计算脑血流量(CBF)、脑血容量(CBV)、平均通过时间(MTT)和达峰时间(TTP),CSVD综合评分法基于M RI评估脑CSVD严重程度。结果:LSA数量与CSVD各项影像学表现及CSVD评分呈负相关。CSVD严重程度与LSA数量的调整优势比(OR)如下:LSA>20组vs.LSA=10~20组为0.31,LSA=10~20组vs.LSA<10组为0.47。单侧LSA=5~10时,同侧基底节区MTT、TTP显著升高,CBF显著降低。单侧LSA=5~10时,同侧基底节区CBV略低,而LSA<5时,CBV显著降低。结论:CSVD患者LSA数量较低,LSA数量与脑灌注呈正相关,与CSVD严重程度呈负相关,脑低灌注可能是其中重要机制。LSA可作为CSVD的一个潜在影像学标志,具有一定临床价值。

Purpose:To investigate the association between the number of lenticulostriate arteries(LSAs)and the cerebral perfusion in CSVD patients,and to determine the correlation between the number of LSAs and CSVD severity.Methods:Five hundred and ninety-four consecutive patients who underwent DSA were enrolled.The number of LSAs was determined on DSA.CTP was used to calculate the CBV,CBF,TTP,and MTT.An SVD compound score was calculated to reflect the severity of CSVD.Results:The number of LSAs was negatively correlated with the SVD scores,and was inversely associated with neuroimaging features of CSVD.The adjusted ORs of the SVD severity were 0.31 for group 1(LSA>20)vs.group 2(LSA=10-20),and 0.47 for group 2 vs.group 3(LSA<10).MTT and TTP was significantly higher and CBF was significantly lower when the number of LSA was 5-10 on each side of the basal ganglia.The CBV was slightly lower when the number of LSA was 5-10,however it was significantly lower when the number of LSA was less than 5 on each side of the basal ganglia.Conclusions:The number of LSAs was lower in CSVD patients.LSA count had a positive correlation with the cerebral perfusion and a negative correlation with CSVD severity;and hypoperfusion might play an important role in this process.