脑小血管疾病的铁敏感MRI评估皮质性脑微梗死。

Kim Wiegertjes, Kwok-Shing Chan, Annemieke Ter Telgte, Benno Gesierich, David G Norris, Catharina Jm Klijn, Marco Duering, Anil M Tuladhar, José P Marques, Frank-Erik de Leeuw
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引用次数: 3

摘要

最近的研究表明,一部分皮层微梗死在T2*上可被识别,但在T1和T2随访图像上不可见。我们的目的是研究急性期后皮质微梗死是否与铁积累有关。RUN DMC - intensive研究是一项包括脑小血管疾病(SVD)患者的系列MRI研究。54名参与者每月接受10次3 T MRI检查,包括扩散加权成像、定量R1 (=1/T1)、R2 (=1/T2)和R2* (=1/T2*)制图,从中获取16名参与者中微梗死区和利益控制区(roi)对应区域内的MRI参数。最后,我们通过重复测量方差分析和事后配对t检验比较病变前后的值,使用病变和对照ROI值之间的平均差异。我们观察到54名参与者中有7人(中位年龄69岁[IQR 66-74], 63%男性)出现21例急性皮质微梗死。R2*图显示,在最后一次可用的随访MRI(梗死后5[5-14]周,中位数[IQR])时,R2*值相对于病变前值增加(p = .08),表明铁积累。我们的数据表明,皮质微梗死与R2*值升高相关,表明铁积累,可能是由于微出血、神经炎症或神经退行性变,有待组织病理学证实。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Assessing cortical cerebral microinfarcts on iron-sensitive MRI in cerebral small vessel disease.

Assessing cortical cerebral microinfarcts on iron-sensitive MRI in cerebral small vessel disease.

Assessing cortical cerebral microinfarcts on iron-sensitive MRI in cerebral small vessel disease.

Assessing cortical cerebral microinfarcts on iron-sensitive MRI in cerebral small vessel disease.

Recent studies suggest that a subset of cortical microinfarcts may be identifiable on T2* but invisible on T1 and T2 follow-up images. We aimed to investigate whether cortical microinfarcts are associated with iron accumulation after the acute stage. The RUN DMC - InTENse study is a serial MRI study including individuals with cerebral small vessel disease (SVD). 54 Participants underwent 10 monthly 3 T MRIs, including diffusion-weighted imaging, quantitative R1 (=1/T1), R2 (=1/T2), and R2* (=1/T2*) mapping, from which MRI parameters within areas corresponding to microinfarcts and control region of interests (ROIs) were retrieved within 16 participants. Finally, we compared pre- and post-lesional values with repeated measures ANOVA and post-hoc paired t-tests using the mean difference between lesion and control ROI values. We observed 21 acute cortical microinfarcts in 7 of the 54 participants (median age 69 years [IQR 66-74], 63% male). R2* maps demonstrated an increase in R2* values at the moment of the last available follow-up MRI (median [IQR], 5 [5-14] weeks after infarction) relative to prelesional values (p = .08), indicative of iron accumulation. Our data suggest that cortical microinfarcts are associated with increased R2* values, indicative of iron accumulation, possibly due to microhemorrhages, neuroinflammation or neurodegeneration, awaiting histopathological verification.

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