Cognitive impairment in cerebral small vessel disease induced by hypertension

Hypertension is a primary risk factor for the progression of cognitive impairment caused by cerebral small vessel disease,the most common cerebrovascular disease.Howeve r,the causal relationship between hypertension and cerebral small vessel disease remains unclear.Hypertension has substantial negative impacts on brain health and is recognized as a risk factor for cerebrovascular disease.Chronic hypertension and lifestyle factors are associated with risks for stro ke and dementia,and cerebral small vessel disease can cause dementia and stroke.Hypertension is the main driver of cerebral small vessel disease,which changes the structure and function of cerebral vessels via various mechanisms and leads to lacunar infarction,leukoaraiosis,white matter lesions,and intracerebral hemorrhage,ultimately res ulting in cognitive decline and demonstrating that the brain is the to rget organ of hypertension.This review updates our understanding of the pathogenesis of hypertensioninduced cerebral small vessel disease and the res ulting changes in brain structure and function and declines in cognitive ability.We also discuss drugs to treat cerebral small vessel disease and cognitive impairment.

Concepts and opportunities for repair in cerebral microvascular disease and white matter stroke

Diffuse changes in white matter resulting from cerebral microvascular disease contribute to cognitive impairment （Jokinen et al., 2011）, declines in global functionality （Inzitari et al., 2009）, and even death （Debette and Markus, 2010）. Twenty years ago, estimations of the clinical incidence of ce- rebral microvascular disease approached 11 million per year in the US alone （Leary and Saver, 2003）. More recent estima- tions suggest the prevalence of diffuse white matter disease and silent brain infarction approaches 20% and increases dramatically in the presence of cardiovascular risk factors （Fanning et al., 2014）.

Association between intercellular adhesion molecule-1 to depression and blood-brain barrier penetration in cerebellar vascular disease

BACKGROUND Cerebral small vessel disease(CSVD)is a prevalent cerebrovascular disease in clinical practice that is often associated with macrovascular disease.A clear understanding of the underlying causes of CSVD remains elusive.AIM To explore the association between intercellular adhesion molecule-1(ICAM-1)and blood-brain barrier(BBB)penetration in CSVD.METHODS This study included patients admitted to Fuyang People’s Hospital and Fuyang Community(Anhui,China)between December 2021 and March 2022.The study population comprised 142 patients,including 80 in the CSVD group and 62 in the control group.Depression was present in 53 out of 80 patients with CSVD.Multisequence magnetic resonance imaging(MRI)and dynamic contrast-enhanced MRI were applied in patients to determine the brain volume,cortical thickness,and cortical area of each brain region.Moreover,neuropsychological tests including the Hamilton depression scale,mini-mental state examination,and Montreal cognitive assessment basic scores were performed.RESULTS The multivariable analysis showed that age[P=0.011;odds ratio(OR)=0.930,95%confidence interval(CI):0.880-0.983]and ICAM-1 levels(P=0.023;OR=1.007,95%CI:1.001-1.013)were associated with CSVD.Two regions of interest(ROIs;ROI3 and ROI4)in the white matter showed significant(both P<0.001;95%CI:0.419-0.837 and 0.366-0.878)differences between the two groups,whereas only ROI1 in the gray matter showed signi-ficant difference(P=0.046;95%CI:0.007-0.680)between the two groups.ICAM-1 was significantly correlated(all P<0.05)with cortical thickness in multiple brain regions in the CSVD group.CONCLUSION This study revealed that ICAM-1 levels were independently associated with CSVD.ICAM-1 may be associated with cortical thickness in the brain,predominantly in the white matter,and a significant increase in BBB permeability,proposing the involvement of ICAM-1 in BBB destruction.

Diffusion tensor imaging pipeline measures of cerebral white matter integrity: An overview of recent advances and prospects

Cerebral small vessel disease(CSVD)is a leading cause of age-related microvascular cognitive decline,resulting in significant morbidity and decreased quality of life.Despite a progress on its key pathophysiological bases and general acceptance of key terms from neuroimaging findings as observed on the magnetic resonance imaging(MRI),key questions on CSVD remain elusive.Enhanced relationships and reliable lesion studies,such as white matter tractography using diffusion-based MRI(dMRI)are necessary in order to improve the assessment of white matter architecture and connectivity in CSVD.Diffusion tensor imaging(DTI)and tractography is an application of dMRI that provides data that can be used to non-invasively appraise the brain white matter connections via fiber tracking and enable visualization of individual patient-specific white matter fiber tracts to reflect the extent of CSVD-associated white matter damage.However,due to a lack of standardization on various sets of software or image pipeline processing utilized in this technique that driven mostly from research setting,interpreting the findings remain contentious,especially to inform an improved diagnosis and/or prognosis of CSVD for routine clinical use.In this minireview,we highlight the advances in DTI pipeline processing and the prospect of this DTI metrics as potential imaging biomarker for CSVD,even for subclinical CSVD in at-risk individuals.

Effects of different regional cerebral blood flow on white matter hyperintensity in CADASIL patients

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy(CADASIL)is an early-onset inherited small vessel disease.Decreased cerebral blood flow(CBF)may contribute to white matter hyperintensity(WMH)severity in CADASIL,but more evidence is needed to support this hypothesis.This study comprised six patients with CADASIL who harbored mutations in the coding sequence of NOTCH3 and twelve age-matched neurologically healthy controls.We collected clinical and imaging data from patients with CADASIL and divided the brain into four regions:WMH,normal-appearing white matter(NAWM),gray matter(GM),and global brain.We analyzed the relationship between CBF of each region and the WMH volume.Compared with the control group,CBF was significantly decreased in all four regions in the CADASIL group.Lower CBF in these regions was correlated with higher WMH volume in CADASIL.CBF in the NAWM,GM and global regions was positively correlated with that in WMH region.However,after correction tests,only CBF in the WMH region but not in NAWM,GM and global regions was associated with WMH volume.Our findings suggest that CBF in the WMH region is an influencing factor of the WMH severity in CADASIL.

Progress on Prevention and Treatment of Cerebral Small Vascular Disease Using Integrative Medicine

Cerebral small vessel disease(CSVD)is a senile brain lesion caused by the abnormal structure and function of arterioles,venules and capillaries in the aging brain.The etiology of CsvD is complex,and disease is often asymptomatic in its early stages.However,as CsvD develops,brain disorders may occur,such as stroke,cognitive dysfunction,dyskinesia and mood disorders,and heart,kidney,eye and systemic disorders.As the population continues to age,the burden of CsvD is increasing.Moreover,there is an urgent need for better screening methods and diagnostic markers for CsvD,in addition to preventive and asymptomatic-and mild-stage treatments.Integrative medicine(IM),which combines the holistic concepts and syndrome differentiations of Chinese medicine with modern medical perspectives,has unique advantages for the prevention and treatment of CsvD.In this review,we summarize the biological markers,ultrasound and imaging features,disease-related genes and risk factors relevant to CsvD diagnosis and screening.Furthermore,we discuss IM-based csvD prevention and treatment strategies to stimulate further research in this field.

MRI Features and Site-specific Factors of Ischemic Changes in White Matter： A Retrospective Study

Brain magnetic resonance imaging （MRI） of the elderly often reveals white matter changes （WMCs） with substantial variability across individuals. Our study was designed to explore MRI features and site-specific factors of ischemic WMCs. Clinical data of consecutive patients diagnosed with ischemic cerebral vascular disease who had undergone brain MRI were collected and analyzed. Multi-logistic regression analysis comparing patients with mild versus severe WMCs was performed to detect independent associations. Analyses of variance （ANOVAs） were used to detect regionally specific differences in lesions. We found that lesion distribution differed significantly across five cerebral areas, with lesions being predominant in the frontal lobe and parieto-occipital area. To explore WMCs risk factors, after adjusting for gender, diabetes mellitus, and hypertension, only age （P〈0.01）, creatinine （P=0.01）, alkaline phosphatase （ALP） （P=0.01） and low-density lipoprotein cholesterol （LDL-C） （P=0.03） were found to be independently associated with severe WMCs. Age （P〈0.001） was strongly associated with WMCs in the frontal lobe while hypertension was independently related to lesions in the basal ganglia （P=0.048） or infratentorial area （P=0.016）. In conclusion, MRI of WMCs showed that ischemic WMCs occurred mostly in the frontal lobe and parieto-occipital area. The infratentorial area was least affected by WMCs. Typically, age-related WMCs were observed in the frontal lobes, while hypertension-related WMCs tended to occur in the basal ganglia and infratentorial area.

Roles of NG2 Glia in Cerebral Small Vessel Disease

Cerebral small vessel disease(CSVD)is one of the most prevalent pathologic processes affecting 5%of people over 50 years of age and contributing to 45%of dementia cases.Increasing evidence has demonstrated the pathological roles of chronic hypoperfusion,impaired cerebral vascular reactivity,and leakage of the blood–brain barrier in CSVD.However,the pathogenesis of CSVD remains elusive thus far,and no radical treatment has been developed.NG2 glia,also known as oligodendrocyte precursor cells,are the fourth type of glial cell in addition to astrocytes,microglia,and oligodendrocytes in the mammalian central nervous system.Many novel functions for NG2 glia in physiological and pathological states have recently been revealed.In this review,we discuss the role of NG2 glia in CSVD and the underlying mechanisms.

脑白质高信号消退的研究进展

脑白质高信号(WMH)普遍存在于老年人群中,与卒中、认知、步态不稳和神经精神症状相关。WMH负荷通常随着年龄的增长而增加,但随着研究的不断深入,发现WMH是动态可变的,在发展过程中可能会部分消退,且可能伴随脑萎缩减缓和认知功能改善,但其确切发生机制、影响因素及临床意义目前尚不明确,且缺少有效逆转WMH的方法。作者综述了WMH消退的相关研究,为临床医师积极干预WMH相关影响因素,促进其在早期阶段逆转,改善患者脑健康提供参考。

脑小血管病患者膀胱过度活动症的影响因素分析

目的 探讨脑小血管病(CSVD)患者膀胱过度活动症(OAB)的影响因素及其与CSVD影像学标志物的相关性。方法 选取2021年1月至2022年12月于包头医学院第二附属医院就诊的老年CSVD患者163例,依据OAB评分量表评估分为OAB组37例和非OAB组126例。记录并比较2组患者简易智能状态检查量表(MMSE)评分、Fazekas量表评分、CSVD影像学总负荷评分。结果 与非OAB组比较,OAB组年龄、尿频、夜尿、尿急、急迫性尿失禁比例、Fazekas量表评分、脑室旁白质高信号(PWMH)评分、脑深部白质高信号(DWMH)评分、CSVD总负荷评分显著增高,MMSE评分显著降低(P<0.05,P<0.01)。PWMH评分、DWMH评分是OAB发生的危险因素(P<0.01)。CSVD患者OAB评分量表评分与Fazekas量表评分、PWMH评分、DWMH评分呈正相关(r=0.533,P=0.001;r=0.462,P=0.004;r=0.398,P=0.015);CSVD患者急迫性尿失禁的发生与Fazekas量表评分、PWMH评分呈正相关(r=0.352,P=0.033;r=0.346,P=0.036)。结论 PWMH、DWMH是CSVD患者OAB的危险因素。

脑小血管病患者血清lncRNA BIRF,lncRNA FAL1表达水平与脑白质病变程度的相关性分析

目的探究脑小血管病(CSVD)患者血清长链非编码RNA(lncRNA)脑缺血相关因子(BIRF)、1号染色体上的局部扩增lncRNA(lncRNA FAL1)表达与脑白质病变(WML)程度的相关性分析。方法选取承德医学院附属医院2021年6月~2023年6月收治的102例CSVD患者,根据WML诊断标准将CSVD患者分为WML组(n=72)和非WML组(n=30)。并根据Fazekas评分进一步将WML组分为轻度WML组(n=24)、中度WML组(n=36)和重度WML组(n=12)。采用实时荧光定量聚合酶链式反应(RT-qPCR)检测血清中lncRNA BIRF,lncRNA FAL1水平;采用Pearson相关分析血清lncRNA BIRF,lncRNA FAL1水平的相关性。采用受试者工作特征(ROC)曲线分析血清lncRNA BIRF,lncRNA FAL1水平对CSVD患者发生重度WML的诊断价值。结果WML组患者年龄(70.50±5.86岁)、高血压史(有/无:43/29例)、糖尿病史(有/无:45/27例)、IL-33(68.35±6.80 pg/ml),IL-18(97.78±9.65 ng/L)、泛素羧基末端水解酶L1(UCH-L1)(0.29±0.10μg/L),lncRNA BIRF水平(2.45±0.30)显著高于非WML组(67.10±5.76岁,11/19例,9/21例,62.48±6.13 pg/ml,92.56±9.37 ng/L,0.24±0.06μg/L,1.02±0.11),血清lncRNA FAL1表达(0.52±0.10)显著低于非WML组(1.04±0.15),差异具有统计学意义(t=2.683,4.518,8.978,4.085,2.510,2.550,25.346,20.500,均P<0.05)。轻度WML组、中度WML组、重度WML组CSVD患者血清lncRNA BIRF水平(2.23±0.23,2.47±0.31,2.82±0.42)依次升高,血清lncRNA FAL1水平(0.60±0.15,0.51±0.09,0.40±0.04)依次降低,差异具有统计学意义(F=14.913,13.899,均P<0.05)。Pearson相关分析,WML组患者血清lncRNA BIRF与lncRNA FAL1水平呈负相关(r=-0.603,P<0.001);WML患者血清lncRNA BIRF与Fazekas评分呈正相关(r=0.483,P<0.001),血清lncRNA FAL1与Fazekas评分呈负相关(r=-0.507,P<0.001)。血清lncRNA BIRF,lncRNA FAL1水平单独及二者联合诊断CSVD患者发生重度WML的AUC(95%CI)分别为0.756(0.641~0.850),0.839(0.733~0.915)和0.892(0.796~0.953),二者联合检测优于血清lncRNA BIRF单独检测(Z=2.111,P=0.035)。结论CSVD伴WML患者血清lncRNA BIRF水平显著升高,lncRNA FAL1水平显著降低,均与CSVD患者WML程度相关。

脑小血管病中脑白质高信号和影像学负荷与临床特征的相关性研究

目的明确脑小血管病中脑白质高信号和影像学负荷与临床特征之间的相关性。方法本研究共纳入121例脑小血管病患者,对入组患者进行病史采集、临床特征分析、认知评估,并行核磁共振检查,对其脑白质病变和影像学负荷进行评分。对上述结果进行分层分析和相关性分析,最后进行线性回归分析明确脑小血管患者脑白质高信号和影像学负荷的临床影响因素。结果在脑小血管病患者中,脑白质高信号与有无中风病史、心血管疾病病史、认知功能有关(P<0.05);影像学负荷评分与有无高血压病、中风和心血管疾病病史以及认知功能有关(P<0.05)。进一步的相关分析和线性回归分析仍然说明脑白质高信号与有无中风病史、认知功能有关(P<0.05),提示影像学负荷评分与有无中风、心血管疾病病史及认知功能有关(P<0.05)。结论认知功能和有无中风病史是影响脑小血管病患者脑白质高信号和影像学总负荷评分的独立危险因素。

平均血小板体积和脑白质高信号对穿支动脉疾病型脑梗死早期神经功能恶化的预测价值

目的探讨平均血小板体积(MPV)和脑白质高信号(WMH)与穿支动脉疾病(PAD)型脑梗死患者早期神经功能恶化(END)的相关性。方法回顾性连续纳入2021年1月至2023年9月苏州市独墅湖医院神经内科收治的经头部MRI等检查诊断的PAD型脑梗死患者,按照入院后7 d内是否发生END分为END组和非END组。收集两组患者的人口学资料、临床资料,包括性别、年龄、体质量指数、高血压病、糖尿病、高脂血症、吸烟、早期(发病7 d内)是否合并肺部感染、入院美国国立卫生研究院卒中量表(NIHSS)评分、入院时收缩压、脑梗死部位(前、后循环供血区)及抗血小板聚集药物治疗方案(单抗、双抗)、白细胞计数、中性粒细胞/淋巴细胞比值、C反应蛋白、血小板计数、血小板压积、MPV、三酰甘油、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血尿酸、同型半胱氨酸、糖化血红蛋白、D-二聚体及纤维蛋白原。根据头部MRI影像,按照改良Fazekas分级,将两组患者的WMH严重程度分为轻度负荷(改良Fazekas分级0~1级)和重度负荷(改良Fazekas分级2~3级)。采用单因素及多因素二元Logistic回归分析MPV和WMH程度与PAD型脑梗死患者发生END的相关性。结果共167例患者纳入本研究,其中END组40例,非END组127例,END发生率24.0%。单因素分析结果显示,END组患者的入院NIHSS评分、糖尿病、MPV以及WMH负荷程度均高于非END组,而血小板计数低于非END组(均P<0.05)。多因素Logistic回归分析显示,MPV和重度负荷WMH是PAD型脑梗死患者发生END的独立影响因素(OR值分别为1.460、2.549,95%CI值分别为1.066~2.000、1.161~5.595,P值分别为0.018、0.020)。受试者工作特征曲线显示,MPV水平及重度负荷WMH程度对PAD型脑梗死患者发生END均有预测价值,曲线下面积分别为0.704(95%CI:0.615~0.793,P=0.001)、0.616(95%CI:0.516~0.716,P=0.028)。结论MPV水平升高和重度负荷WMH是PAD型脑梗死患者发生END的独立影响因素,且MPV的预测价值较重度负荷WMH更高。

烟雾病患者的脑白质损伤及认知功能减退的研究进展

烟雾病(MMD)的特征是颈内动脉的颅内段部分及其近端分支的进行性狭窄或闭塞,导致缺血性或出血性卒中,致残率、病死率高。已有很多研究发现,MMD患者普遍存在脑白质的高信号,并有不同程度的脑白质损伤。同时MMD患者认知功能也被发现存在普遍减退的现象,在手术治疗后白质损伤及认知功能也都会得到一定的改善,说明MMD患者脑白质损伤及认知功能下降存在一致性。本文综述了MMD白质损伤的研究进展及较为全面的评估方法,并对血运重建术后MMD患者白质损伤及认知功能改善情况进行了总结。

大脑中动脉粥样硬化斑块易损性与脑白质高信号的相关性研究

目的:通过对比分析基于Fazekas评分的不同严重程度脑白质高信号(WMHs)患者的大脑中动脉管壁改变和斑块特征,探讨斑块易损性参数与脑白质高信号严重程度的相关性。方法:将2021年5月-2023年5月本院收治的因怀疑大脑中动脉粥样硬化斑块而行常规序列颅脑MR扫描及大脑中动脉M1段高分辨管壁成像检查的99例住院患者纳入本研究。基于颅脑MRI平扫图像,根据改良Fazekas评分标准将患者分为2组:无和轻度WMHs组(Fazekas 0~2分)57例,中重度WMHs组(Fazekas 3~6分)42例。采用两独立样本t检验、非参数Mann-Whitney U检验和卡方分析比较两组之间血管狭窄程度、斑块分布、管壁重构模式、斑块内出血和斑块负荷等易损性参数的差异。采用Spearman相关分析和二元logistic回归分析确定易损斑块与WMHs之间的关系。结果:年龄及血脂异常和斑块内出血占比在两组间的差异有统计学意义(P<0.05),中和重度WMHs组患者年龄更大,血脂异常更常见,斑块内出血比例更高。相关性分析显示,年龄,血脂异常和斑块内出血均与白质高信号等级呈正相关(r=0.276、0.215、0.321,P均<0.05)。二元logistics回归分析结果显示年龄和斑块内出血是WMHs严重程度的独立危险因素[OR=1.083(1.030,1.139),P=0.002;OR=4.991(1.459,17.072),P=0.010]。结论:年龄、血脂异常和斑块内出血与WMHs严重程度相关,年龄和斑块内出血是WMHs严重程度的独立影响因素,提示颅内大动脉粥样硬化易损性斑块与脑小血管病具有相关性,有助于指导临床制订个性化的治疗方案。

腔隙性脑梗死患者脑白质病变情况与缺氧诱导因子1α相关性研究

目的:探究腔隙性脑梗死(LACI)患者脑白质病变情况与缺氧诱导因子1α(HIF-1α)的相关性。方法:收集196例LACI患者为研究对象,患者均完成MRI检查,并采用Fazekas量表评估纳入者脑白质病变情况;同时留取患者入院确诊时静脉血样,用于测定血清HIF-1α、半胱氨酸蛋白酶-3(Caspase-3);分析血清HIF-1α与脑白质病变情况的关系。结果:纳入者中72.45%出现脑白质病变,其中42.96%轻度病变,33.80%中度病变、23.24%重度病变。与非脑白质病变组相比,病变组患者年龄和高血压占比明显增大,血清HIF-1α和Caspase-3水平明显升高(均P<0.05)。脑白质不同程度病变者收缩压和血清HIF-1α和Caspase-3水平比较差异具有统计学意义(均P<0.01),重度病变者明显高于中度病变者,中度病变者高于轻度病变者(均P<0.05)。Logistic回归分析显示,收缩压和血清HIF-1α、Caspase-3水平均是影响LACI患者脑白质病变程度的危险因素(均P<0.05)。受试者工作特征(ROC)曲线分析显示,血清HIF-1α对LACI患者脑白质病变发生及重度脑白质病变均具有一定预测价值(AUC=0.840、0.874)。结论:LACI伴有脑白质病变患者体内HIF-1α呈高表达状态,且其表达水平升高与脑白质病变加重有关。

脑小血管病影像学标志物与认知功能障碍相关性研究进展

脑小血管疾病(cerebral small vessel disease,CSVD)的部分患者会出现认知功能下降并可能进展为痴呆,严重降低患者的生活质量。目前关于CSVD影像学标志物与认知功能障碍的相关性研究表明,脑白质高信号、血管周围间隙扩大、脑微出血、腔隙性脑梗死的分布位置、严重程度对各认知域产生不同影响,CSVD导致的认知功能障碍可能与炎症因子间接影响和脑组织纤维束破坏等机制相关。但CSVD影像学标志物与认知功能的关系及其相关机制还需要更进一步研究加以验证。

径线法评估脑白质高信号相关脑萎缩的价值

目的 探讨关于使用径线法评估脑白质高信号(WMH)相关脑萎缩严重程度的可行性。方法 回顾性选择2023年9至10月扬中市人民医院临床检查者和健康体检者131例,按WMH严重度分组并测算各组的双尾状核指数Evans指数及哈氏值、第三脑室宽度、脑室指数、侧脑室体部指数、外侧裂宽度。对各组所测经线指标进行单因素方差分析,评估不同WMH严重度时脑萎缩情况是否存在差异。结果 不同WMH严重度的受检者其哈氏值、第三脑室宽度、脑室指数、侧脑室体部指数、Evans指数、双尾状核指数及脑沟宽度存在统计学差异。组间多重对比结果显示仅双尾状核指数在不同WMH分组间差异均有统计学意义。结论 径线法可以评估WMH相关的脑萎缩严重程度,常用的径线指标中双尾状核指数对WMH相关的脑萎缩最为敏感。

帕金森患者脑白质微结构及血脂水平变化与认知功能的相关性分析

目的探讨帕金森病(PD)患者脑白质微结构及血脂水平变化与认知功能的相关性。方法选取2021年1月至2022年12月我院收治的176例PD患者为观察组,纳入同期健康体检者89例为对照组,比较两组脑白质微结构变化、血脂水平以及认知功能差异,分析PD病患者脑白质微结构及血脂水平变化与认知功能的相关性。结果观察组脑白质各区域FA值均低于对照组,各项血脂指标均低于对照组(P<0.05);176例PD患者中认知功能异常组59例(33.52%),认知功能正常组117例(66.48%),认知功能异常组PD患者各项Moca评分均低于认知功能正常组,脑白质各区域FA值均低于认知功能正常组,TC、LDL-C、HDL-C、ApoA1低于认知功能正常组(P<0.05),两组TG、ApoB比较差异无统计学意义(P>0.05);PD患者脑白质各区域FA值及TC、LDL-C、HDL-C、ApoA1水平均与Moca评分呈正相关(P<0.05)。结论PD患者脑白质微结构异常及血脂指标水平降低,其中脑白质各区域FA值、TC、LDL-C、HDL-C、ApoA1与认知功能异常相关,可用于临床参考。

线上BOPPPS教学模式在放射科住院医师规范化培训中的应用

目的探讨线上导言、学习目标、预评估、参与式学习、后评估和总结(bridge-in,objective/outcome,pre-assessment,participatory learning,post-assessment,summary,BOPPPS)教学模式在放射科住院医师规范化培训中的应用效果,为促进放射影像学的教学改革提供参考。方法2021年9月—2022年9月,选取浙江大学医学院附属第二医院的放射科住院医师规范化培训(住培)学员48名,基于计算机程序随机分配为试验组(n=24)和对照组(n=24)。试验组使用线上BOPPPS教学模式,对照组采用传统线上教学。以脑小血管病(cerebral small vessel disease,CSVD)评估为教学内容,分析比较2组专业理论知识掌握程度和住培学员满意度。结果试验组住培学员在基础部分的脑室旁脑白质高信号评分低于对照组,并且在大多数与脑小血管病相关的高级问题上表现出色,包括半卵圆中心扩大的血管周围间隙、内侧颞叶萎缩和大脑微梗死得分,差异均有统计学意义(P<0.05)。试验组的基础部分总得分与对照组相似,但在高级问题部分以及理论考核总分上优于对照组[(5.38±1.10)分vs.(4.04±1.37)分],差异有统计学意义(P<0.05)。结论采用线上BOPPPS教学模式对放射科住院医师的规范化培训更为有效,相比传统线上教学有一定的优势。