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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Susceptibility Vessel Sign in Deep Perforating Arteries in Patients with Recent Small Subcortical Infarcts
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Susceptibility Vessel Sign in Deep Perforating Arteries in Patients with Recent Small Subcortical Infarcts

机译：易感性血管在近期小型梗死患者患者中的深层穿孔动脉

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Objectives: Recent small subcortical infarcts (RSSI) are considered an acute manifestation of cerebral small vessel disease. Paramagnetic signals in perforating arteries supplying RSSI may be detected on T2*-relaxation derived sequences on MRI and is defined as susceptibility vessel sign (SVS). We aimed to study the prevalence of SVS in patients with RSSI, and explore whether its identification is related to cerebral small vessel disease markers. Materials and Methods: We selected patients with RSSI identified on MRI during admission from a single-center stroke registry. The main demographic and clinical features, including vascular risk factors, were collected. Radiological features of RSSI and cerebral small vessel disease [white matter hyperintensities in deep and periventricular regions, enlarged perivascular spaces, lacunae, microbleeds, and brain atrophy] were described using validated qualitative scores. The presence of SVS was assessed on T2*gradient-echo or other susceptibility-weighted imaging. We compared the clinical and radiological features of patients with or without SVS in uni- and multivariate models. Results: Out of 210 patients with an RSSI on an MRI, 35 (17%) showed SVS. The proportion of SVS+ patients was similar in different susceptibility imaging modalities (p=.64). Risk factor profiles and clinical course were similar in SVS+ and SVS- patients. SVS+ patients had a higher grade of deep white matter hyperintensities and brain atrophy, more lacunae (p=.001, p=.034, p=.022, respectively), and a similar degree of the rest of radiological variables, compared to SVS- patients. In the multivariate analysis, the grade of deep white matter hyperintensities was the only independent factor associated with SVS [OR 3.1 (95% CI, 1.5-6.4)]. Conclusions: SVS in patients with RSSI is uncommon and related to a higher grade of deep white matter hyperintensities. Pathophysiological mechanisms underlying the deposition of hemosiderin in the path of occluded perforating arteries are uncertain and might include endothelial dysfunction or embolic mechanisms.
机译：目的：近期皮质下小梗死（RSSI）被认为是脑小血管疾病的急性表现。提供RSSI的穿通动脉中的顺磁信号可在MRI上的T2*弛豫衍生序列上检测到，并被定义为易感血管征（SVS）。我们旨在研究RSSI患者SVS的患病率，并探讨其识别是否与脑小血管疾病标志物相关。材料和方法：我们从单中心卒中登记处选择入院时在MRI上确认为RSSI的患者。收集主要的人口统计学和临床特征，包括血管危险因素。RSSI和脑小血管疾病的放射学特征[深部和脑室周围区域的白质高信号、血管周围间隙增大、腔隙、微出血和脑萎缩]通过验证的定性评分进行描述。通过T2*梯度回波或其他敏感性加权成像评估SVS的存在。我们在单变量和多变量模型中比较了有无SVS患者的临床和放射学特征。结果：在210例MRI显示RSSI的患者中，35例（17%）显示SVS。SVS+患者的比例在不同的易感性成像模式中相似（p=0.64）。SVS+和SVS-患者的危险因素分布和临床病程相似。与SVS患者相比，SVS+患者的深部白质高信号和脑萎缩程度更高，腔隙更多（分别为p=0.001、p=0.034、p=0.022），其他放射学变量的程度相似。在多变量分析中，深白质高信号分级是与SVS相关的唯一独立因素[OR 3.1（95%可信区间，1.5-6.4）]。结论：RSSI患者的SVS不常见，且与较高级别的深部白质高信号有关。含铁血黄素在阻塞的穿通动脉中沉积的病理生理机制尚不确定，可能包括内皮功能障碍或栓塞机制。

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