增龄相关性脑小血管病合并特发性正常压力性脑积水的影像学特征分析  

Analysis of imaging features of age-related cerebral small vessel disease with idiopathic normal pressure hydrocephalus

作　　者：刘三鑫 宋康宇 李钰 陈小东 门雪娇[1] 卢婷婷[1] 黄雪泓 陆正齐[1] 伍爱民[1] Liu Sanxin;Song Kangyu;Li Yu;Chen Xiaodong;Men Xuejiao;Lu Tingting;Huang Xuehong;Lu Zhengqi;Wu Aimin(Department of Neurology,Psychological and Neurological Diseases Research Center,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院神经内科,精神与神经疾病研究中心,广州510630

出　　处：《中华医学杂志》2020年第43期3402-3406,共5页National Medical Journal of China

基　　金：广州市重点研发计划(202007030010);广州市健康医疗协调创新重大专项(201704020222)。

摘　　要：目的:探究增龄相关性脑小血管病(ArCSVD)合并特发性正常压力性脑积水(INPH)的影像学特征。方法:回顾性分析中山大学附属第三医院2015年12月至2020年3月收治的ArCSVD合并INPH的病例10例,均符合入组和排除标准,完成头颅MRA平扫、T 2 FLAIR和SWI序列,对其进行深髓静脉征(DMVs)评分、INPH严重程度(DESH评分)评估、皮质/皮质下和深部微出血(CMBs)个数统计、侧脑室旁和深部脑白质损伤(WMH)严重程度(Fazekas评分)评估以及CSVD影像学负担评分(Burden评分),并采用Spearman相关分析评价DMVs、DESH评分与CMBs、WMH和Burden评分的相关性。结果:DMVs与DESH评分明显正相关(r=0.9659,P<0.0001);DMVs、DESH评分与皮质/皮质下CMBs和深部CMBs均无明显相关性;DMVs、DESH评分与深部WMH均无明显相关性;10例病例侧脑室旁WMH评分均为3分,Burden评分均为4分。结论:DMVs可能是ArCSVD合并INPH严重程度的指标,但本研究病例数较少,尚需更多的病例数进一步验证。Objective To explore the imaging features in age-related cerebral small vessel disease(ArCSVD)with idiopathic normal pressure hydrocephalus(INPH).Methods Ten cases of age-related cerebral small vessel disease(CSVD)with idiopathic normal pressure hydrocephalus admitted to the Third Affiliated Hospital of Sun Yat-sen University from December 2015 to March 2020 were retrospective analyzed,all patients met the inclusion and exclusion criteria,and completed the head Magnetic resonance angiography plain scan,T2 fluid attenuated inversion recovery and Susceptibility Weighted Imaging sequence.Deep marrow venous signs(DMVs),INPH severity(DESH score),cortical/subcortical and deep microhemorrhages(CMBs)statistics,paraventricular and deep white matter damage(WMH)severity and CSVD imaging burden score were acquired,and correlations of DMVs and DESH scores with CMBs,WMH and Burden scores were evaluated using Spearman correlation analysis.Results DMVs and DESH scores were significantly and positively correlated(r=0.9659,P<0.0001).DMVs and DESH scores were not significantly correlated with cortical/subcortical CMBs and deep CMBs.Likewise,DMVs and DESH scores were not significantly correlated with deep WMH.The WMH score of paraventricular of the 10 cases was 3 points,and the Burden score was 4 points.Conclusion DMVs may be an indicator of the severity of ArCSVD with INPH,due to the small sample size of the current study,more cases are needed for further verification.

关 键 词：脑小血管病 特发性正常压力性脑积水 深髓静脉 

分 类 号：R742.7[医药卫生—神经病学与精神病学] R743[医药卫生—临床医学]