大脑深髓静脉增加对脑小血管病严重程度的预测价值

Predictive Value of Increased Cerebral Deep Medullary Vein on the Severity of Small Cerebrovascular Disease

目的探究大脑深髓静脉(DMV)与脑小血管病(CSVD)总体负荷的关系。方法入组2017年6月至2020年9月就诊于上海市第五人民医院的CSVD高危受试者280例。所有入组受试者均有全脑磁共振(MR)全序列扫描和常规血液生化检查资料。应用MR SWI序列评估DMV负荷,应用国际通用的CSVD评分评估CSVD总体负荷,依据CSVD总体负荷评分中脑白质高信号(WMH)是否得分分为轻度WMH组(CSVD总体负荷1~2分54例)和重度WMH组(CSVD总体负荷3~4分,226例)。应用有序Logistic回归分析评价DMV与WMH以及与CSVD总体负荷的关系。结果 280例受试者的多因素有序Logistic回归分析结果表明,DMV评分与WMH存在相关性(P<0.001),可提示WMH严重程度。年龄(P=0.009)、高血压病(P=0.048)和DMV评分(P<0.001)与CSVD总体负荷评分存在相关性。DMV评分能较好的诊断重度CSVD患者(AUC=0.842,P<0.001)。结论 DMV评分与WMH严重程度以及CSVD总体负荷相关,且对CSVD的严重程度具有一定的预测价值。

Aim To explore the relationship between deep medullary vein and the overall load of cerebral small vessel disease(CSVD). Methods Subjects with CSVD high-risk who admitted in Shanghai Fifth People’s Hospital from June 2017 to September 2020 were enrolled continuously. All subjects completed whole brain magnetic resonance full sequence scanning and routine blood biochemical examination. The DMV load was evaluated by SWI sequence, and the whole brain burden was evaluated by international CSVD score. The relationship between DMV and WMH was evaluated by ordered Logistic regression model and the correlation between DMV and total CSVD score was also detected.Results A total of 280 subjects were enrolled in this study. According to the results of ordered Logistic regression analysis, DMV score(P<0.001) also had relationship with WMH and could indicate the severity of WMH. Age(P=0.009), history of hypertension(P=0.048) and DMV score(P<0.001) were correlated with the overall CSVD burden. DMV score can be used to diagnose severe CSVD subjects(overall CSVD load 3-4 points)(AUC = 0.842, P<0.001) better. Conclusion DMV score is related with the overall CSVD burden, and has a certain predictive value for the severity of burden.