CAJ | 학술논문

背景:皮质下缺血性脑梗死在脑血管病中最为常见,但其具体的影像学表现与血管性痴呆的关系目前仍存在较大争议.目的:探讨皮质下缺血性脑梗死CT表现与血管性痴呆之间的关系.设计:以诊断为依据,在双肓情况下采用完全随机相互对照的横断面、回顾性病例对照研究.地点和对象:研究对象为1999-10/2002-01来西安交通大学第二医院就诊的128例CT证实有皮质下多发脑梗死患者,其中女68例,男60例,年龄54-89岁.方法:对比分析皮质下多发性脑梗死有痴呆和无痴呆患者的CT表现.主要观察指标:皮质下脑梗死的发生部位、体积及数目;伴随脑白质疏松的程度及脑萎缩指标的测量.结果:痴呆组中额叶皮质下、内囊前肢、尾状核、半卵圆中心前部、侧脑室体旁前部白质及丘脑梗死发生率、平均梗死灶数目及平均梗死体积均大于对照组(P＜0.05);3级(3.%,18/60)、4级(32%,19/60)脑白质疏松出现率显著高于对照组(15%,10/68;7%,5/68;x2=4.81,12.22,P＜0.05);脑萎缩指数测量值明显大于对照组(P＜0.05).非条件Logistic回归分析额叶皮质下及丘脑梗死灶数目、侧脑室旁前部白质梗死灶体积、脑白质疏松以及脑皮层萎缩的程度与血管性痴呆的发生显著相关.结论:皮质下多发脑梗死性痴呆与梗死灶的部位、数目、体积和脑白质疏松及皮质萎缩的程度密切相关.
배경:피질하결혈성뇌경사재뇌혈관병중최위상견,단기구체적영상학표현여혈관성치태적관계목전잉존재교대쟁의.목적:탐토피질하결혈성뇌경사CT표현여혈관성치태지간적관계.설계:이진단위의거,재쌍황정황하채용완전수궤상호대조적횡단면、회고성병례대조연구.지점화대상:연구대상위1999-10/2002-01래서안교통대학제이의원취진적128례CT증실유피질하다발뇌경사환자,기중녀68례,남60례,년령54-89세.방법:대비분석피질하다발성뇌경사유치태화무치태환자적CT표현.주요관찰지표:피질하뇌경사적발생부위、체적급수목;반수뇌백질소송적정도급뇌위축지표적측량.결과:치태조중액협피질하、내낭전지、미상핵、반란원중심전부、측뇌실체방전부백질급구뇌경사발생솔、평균경사조수목급평균경사체적균대우대조조(P＜0.05);3급(3.%,18/60)、4급(32%,19/60)뇌백질소송출현솔현저고우대조조(15%,10/68;7%,5/68;x2=4.81,12.22,P＜0.05);뇌위축지수측량치명현대우대조조(P＜0.05).비조건Logistic회귀분석액협피질하급구뇌경사조수목、측뇌실방전부백질경사조체적、뇌백질소송이급뇌피층위축적정도여혈관성치태적발생현저상관.결론:피질하다발뇌경사성치태여경사조적부위、수목、체적화뇌백질소송급피질위축적정도밀절상관.
BACKGROUND: Subcortical ischemic infarct is commonly seen in cerebral vascular disease, but the relationship between its CT findings and vascular dementia still remains controversial.OBJECTIVE: To explore the correlation of CT findings of subcortical ischemic vascular disease and vascular dementia.DESIGN: A retrospective cross-sectional trial on the basis of diagnosis.SETTING and PARTICIPANTS: Totally 128 patients confirmed by CT with subcortical multi-infarct were included from October 1999 to January 2002. Among them, 68 were female and 60 were male, aged from 54 to 89.METHOD: Comparative analysis was performed in the CT manifestations of the subcortical infarct patients with or without dementia.MAIN OUTCOME MEASURES: Locations, size and number of subcor tical infarcts, degree of leukoaraiosis (LA) and index of brain atrophy.RESULTS: Frequency, mean number and mean size of the infarcts in subcortex of lobus frontalis, anterior capsula interna, nucleus caudatus,anterior centrum semiovale, and anterior white matter around the body of ventriculus lateralis and thalamus were significantly larger in the dementia group than in the control group ( P ＜ 0. 05 ) . Leukoaraiosis (LA) of grade Ⅲ or grade Ⅳ was more common in the dementia group than in control group ( P ＜ 0.05 ). Mean width of the cerebral sulci, mean width of sulcus lateralis, index of frontal eminence and VBR in the dementia group were significantly larger than in the control group( P ＜ 0. 05). In addition, unconditioned logistic regression analysis showed that the number of infarcts in subcortex of lobus frontalis and thalamus, size of infarcts in anterior white matter around the body of ventriculus lateralis and degree of leukoaraiosis and accompanied brain atrophy were significantly correlated with vascular dementia.CONCLUSION: Subcortical multi-infarct dementia may be closely correlated with the number, location and size of infarcts as well as the degree of leukoaraiosis and brain atrophy.