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目的探讨脑白质疏松(LA)的相对脑血流量(rCBF)与LA严重程度的关系及脑微出血(CMBs)与LA分级的相关性。方法搜集经MRI检查发现的LA患者30例(男10例,女20例,年龄51~87岁,平均68.7岁)和无脑白质异常者15例(男9例,女6例,年龄55~78岁,平均63岁)纳为研究对象,采用动脉自旋标记(ASL)技术测出半卵圆中心、侧脑室前角、侧脑室后角病灶及病灶周围正常白质的rCBF值,LA严重程度分为0~3级,分析rCBF值与严重程度分级的关系。采用SWI检测LA患者CMBs的情况,依据CMBs数量分为0~3级,分析LA分级与CMBs分级的相关性,并分别采用配对t检验、Wilcoxon秩和检验和Kruskal-wallis H检验。结果半卵圆中心、侧脑室前角、侧脑室后角病灶区较灶周正常白质的rCBF值明显减低,并且随着LA分级的加重,病灶区rCBF值逐渐减低,两者存在一定相关性(rs=-0.82、-0.75、-0.79,P=0.00);LA分级与CMBs分级存在一定相关性(rs=0.532,P=0.00)。结论 ASL联合SWI技术可发现LA患者微小动静脉变化。随着LA分级的加重,病灶区rCBF值逐渐减低;LA与CMBs分级呈正相关。
Objective To investigate the relationship between relative cerebral blood flow (rCBF) and severity of LA and cerebral microbleeds (CMBs) and LA grade in patients with leukoaraiosis (LA). Methods Totally 30 LA patients (10 males and 20 females, aged 51-87 years, mean age 68.7 years) and 15 cases without leukomalacia (9 males and 6 females, aged 55 ~ 78 years old, with an average of 63 years) were included in the study. The rCBF values of semiotid center, anterior horn of lateral ventricle, posterior horn of lateral ventricle and normal white matter around lesion were measured by ASL. LA severity Divided into 0 to 3 levels, analysis of rCBF value and the severity of the relationship. According to the number of CMBs, the CMBs were classified into 0 ~ 3 levels by SWI. The correlation between LA grade and CMBs grade was analyzed. The paired t-test, Wilcoxon rank sum test and Kruskal-wallis H test were used respectively. Results The rCBF values of the centrum semiovale, the anterior horn of the lateral ventricle and the posterior horn of the lateral ventricle were significantly lower than those of normal white matter of the peritoneal cavity. The rCBF value of the lesion area gradually decreased with the increase of LA grade, and there was some correlation between them rs = -0.82, -0.75, -0.79, P = 0.00). There was a correlation between LA classification and CMBs classification (rs = 0.532, P = 0.00). Conclusion ASL combined with SWI can detect small arteriovenous changes in patients with LA. With the increase of LA grade, rCBF value of lesion area gradually decreased; LA was positively correlated with CMBs grade.