{"title":"脑内动脉狭窄与皮质梗死、腔隙、白质高信号和脑萎缩之间的关系：一项基于人群的研究结果","authors":"Liv-Hege Johnsen, Marit Herder, Torgil Riise Vangberg, Jørgen Gjernes Isaksen, Ellisiv B Mathiesen","doi":"10.1159/000548650","DOIUrl":null,"url":null,"abstract":"<p><p><p>Introduction: Intracranial artery stenosis (ICAS) is a significant contributor to cortical infarcts, and studies have also shown associations between ICAS and structural brain changes, such as lacunes, white matter hyperintensities (WMHs), and brain atrophy. We aimed to assess the associations between ICAS and cortical infarcts, lacunes, WMHs, and brain parenchymal fraction (BPF) in a general population.</p><p><strong>Methods: </strong>We included 1,842 participants (981 women and 861 men) aged 40-84 years who participated in a cross-sectional population-based study. Three-dimensional time-of-flight magnetic resonance angiography was used for the assessment of ICAS, while 3D T2-fluid-attenuated inversion recovery sequences, 3D T1-weighted sequences, and susceptibility-weighted images were used for evaluation of brain structure. ICAS was defined as a ≥50% focal narrowing of the intracranial arterial flow diameter. WMHs were assessed by the Fazekas score and automated volumetric measurements. BPF was used as a proxy for brain atrophy.</p><p><strong>Results: </strong>The 111 participants (6.0%) with ICAS had significantly more cortical infarcts (23.4% vs. 5.5%, p < 0.001) and lacunes (27.0% vs. 7.7%, p < 0.001) compared to participants without ICAS (1,731). Multivariable-adjusted analysis showed an independent association between ICAS and cortical infarcts (OR: 2.23, 95% CI: 1.27 to 3.90, p = 0.005) and lacunes (OR 2.05, 95% CI: 1.24 to 3.41, p = 0.005), mainly driven by lacunes in the posterior circulation (OR: 4.76, 95% CI: 1.75 to 12.97, p = 0.002). ICAS was independently associated with moderate-to-severe periventricular Fazekas score (OR 2.04, 95% CI: 1.26 to 3.28) and BPF (β-coefficient -0.0131, 95% CI: -0.0232 to -0.0030). There was no significant association between ICAS and deep moderate-to-severe Fazekas score or WMH volumes.</p><p><strong>Conclusion: </strong>ICAS was associated with both cortical infarcts in the anterior and posterior circulation and with lacunes in the posterior circulation. The results also indicate a relationship between ICAS and periventricular WMHs and brain atrophy. </p>.</p>","PeriodicalId":45709,"journal":{"name":"Cerebrovascular Diseases Extra","volume":" ","pages":"225-232"},"PeriodicalIF":2.1000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12659642/pdf/","citationCount":"0","resultStr":"{\"title\":\"Association between Intracerebral Artery Stenosis and Cortical Infarcts, Lacunes, White Matter Hyperintensities and Brain Atrophy: Results from a Population-Based Study.\",\"authors\":\"Liv-Hege Johnsen, Marit Herder, Torgil Riise Vangberg, Jørgen Gjernes Isaksen, Ellisiv B Mathiesen\",\"doi\":\"10.1159/000548650\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><p>Introduction: Intracranial artery stenosis (ICAS) is a significant contributor to cortical infarcts, and studies have also shown associations between ICAS and structural brain changes, such as lacunes, white matter hyperintensities (WMHs), and brain atrophy. We aimed to assess the associations between ICAS and cortical infarcts, lacunes, WMHs, and brain parenchymal fraction (BPF) in a general population.</p><p><strong>Methods: </strong>We included 1,842 participants (981 women and 861 men) aged 40-84 years who participated in a cross-sectional population-based study. Three-dimensional time-of-flight magnetic resonance angiography was used for the assessment of ICAS, while 3D T2-fluid-attenuated inversion recovery sequences, 3D T1-weighted sequences, and susceptibility-weighted images were used for evaluation of brain structure. ICAS was defined as a ≥50% focal narrowing of the intracranial arterial flow diameter. WMHs were assessed by the Fazekas score and automated volumetric measurements. BPF was used as a proxy for brain atrophy.</p><p><strong>Results: </strong>The 111 participants (6.0%) with ICAS had significantly more cortical infarcts (23.4% vs. 5.5%, p < 0.001) and lacunes (27.0% vs. 7.7%, p < 0.001) compared to participants without ICAS (1,731). Multivariable-adjusted analysis showed an independent association between ICAS and cortical infarcts (OR: 2.23, 95% CI: 1.27 to 3.90, p = 0.005) and lacunes (OR 2.05, 95% CI: 1.24 to 3.41, p = 0.005), mainly driven by lacunes in the posterior circulation (OR: 4.76, 95% CI: 1.75 to 12.97, p = 0.002). ICAS was independently associated with moderate-to-severe periventricular Fazekas score (OR 2.04, 95% CI: 1.26 to 3.28) and BPF (β-coefficient -0.0131, 95% CI: -0.0232 to -0.0030). There was no significant association between ICAS and deep moderate-to-severe Fazekas score or WMH volumes.</p><p><strong>Conclusion: </strong>ICAS was associated with both cortical infarcts in the anterior and posterior circulation and with lacunes in the posterior circulation. The results also indicate a relationship between ICAS and periventricular WMHs and brain atrophy. </p>.</p>\",\"PeriodicalId\":45709,\"journal\":{\"name\":\"Cerebrovascular Diseases Extra\",\"volume\":\" \",\"pages\":\"225-232\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12659642/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cerebrovascular Diseases Extra\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1159/000548650\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/10/10 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cerebrovascular Diseases Extra","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1159/000548650","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/10/10 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 0
摘要
背景：颅内动脉狭窄（ICAS）是皮质梗死的重要诱因，研究也表明ICAS与脑结构变化（如脑凹窝、白质高信号（WMHs）和脑萎缩）之间存在关联。我们的目的是评估一般人群中ICAS与皮质梗死、腔隙、WMHs和脑实质分数（BPF）之间的关系。方法：我们纳入了1842名参与者（981名女性和861名男性），年龄在40至84岁之间，他们参加了一项以人群为基础的横断面研究。采用三维飞行时间磁共振血管造影（3D- tof - mra）评估ICAS，采用3D t2 -流体衰减反转恢复（FLAIR）序列、3D t1加权序列和敏感性加权图像（SWI）评估脑结构。ICAS定义为颅内动脉血流直径局灶性狭窄≥50%。通过Fazekas评分和自动体积测量来评估wmh。BPF被用作脑萎缩的替代指标。结果：111例ICAS患者（6.0%）皮质梗死（23.4% vs. 5.5%, p < 0.001）和腔隙（27.0% vs. 7.7%, p）明显增加。结论：ICAS与前后循环皮质梗死和后循环腔隙均相关。结果还表明ICAS与脑室周围wmh和脑萎缩之间存在关系。
Association between Intracerebral Artery Stenosis and Cortical Infarcts, Lacunes, White Matter Hyperintensities and Brain Atrophy: Results from a Population-Based Study.
Introduction: Intracranial artery stenosis (ICAS) is a significant contributor to cortical infarcts, and studies have also shown associations between ICAS and structural brain changes, such as lacunes, white matter hyperintensities (WMHs), and brain atrophy. We aimed to assess the associations between ICAS and cortical infarcts, lacunes, WMHs, and brain parenchymal fraction (BPF) in a general population.
Methods: We included 1,842 participants (981 women and 861 men) aged 40-84 years who participated in a cross-sectional population-based study. Three-dimensional time-of-flight magnetic resonance angiography was used for the assessment of ICAS, while 3D T2-fluid-attenuated inversion recovery sequences, 3D T1-weighted sequences, and susceptibility-weighted images were used for evaluation of brain structure. ICAS was defined as a ≥50% focal narrowing of the intracranial arterial flow diameter. WMHs were assessed by the Fazekas score and automated volumetric measurements. BPF was used as a proxy for brain atrophy.
Results: The 111 participants (6.0%) with ICAS had significantly more cortical infarcts (23.4% vs. 5.5%, p < 0.001) and lacunes (27.0% vs. 7.7%, p < 0.001) compared to participants without ICAS (1,731). Multivariable-adjusted analysis showed an independent association between ICAS and cortical infarcts (OR: 2.23, 95% CI: 1.27 to 3.90, p = 0.005) and lacunes (OR 2.05, 95% CI: 1.24 to 3.41, p = 0.005), mainly driven by lacunes in the posterior circulation (OR: 4.76, 95% CI: 1.75 to 12.97, p = 0.002). ICAS was independently associated with moderate-to-severe periventricular Fazekas score (OR 2.04, 95% CI: 1.26 to 3.28) and BPF (β-coefficient -0.0131, 95% CI: -0.0232 to -0.0030). There was no significant association between ICAS and deep moderate-to-severe Fazekas score or WMH volumes.
Conclusion: ICAS was associated with both cortical infarcts in the anterior and posterior circulation and with lacunes in the posterior circulation. The results also indicate a relationship between ICAS and periventricular WMHs and brain atrophy.
期刊介绍：
This open access and online-only journal publishes original articles covering the entire spectrum of stroke and cerebrovascular research, drawing from a variety of specialties such as neurology, internal medicine, surgery, radiology, epidemiology, cardiology, hematology, psychology and rehabilitation. Offering an international forum, it meets the growing need for sophisticated, up-to-date scientific information on clinical data, diagnostic testing, and therapeutic issues. The journal publishes original contributions, reviews of selected topics as well as clinical investigative studies. All aspects related to clinical advances are considered, while purely experimental work appears only if directly relevant to clinical issues. Cerebrovascular Diseases Extra provides additional contents based on reviewed and accepted submissions to the main journal Cerebrovascular Diseases.
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