CAJ | 학술논문

目的探讨脑微出血（cerebral microbleeds，CMBs）与脑白质病变（white matter lesions，WML）及腔隙性梗死（lacunar infarcts，LI）的关系。 　　方法连续纳入2010年2月至2012年2月解放军总医院南楼神经内科病房根据病史及头颅影像学检查确诊患有脑血管病或具有高血压、糖尿病、高脂血症等脑血管病危险因素者217例。采用G E公司1.5T磁共振成像行头颅常规序列及T2*血管加权成像（T2 star weighted angiography，SWAN）序列扫描。记录深部及皮层部位CMBs病灶数，按照Fazekas评分和Scheltens改良量表将脑室旁白质高信号（peri-ventricular hyperintensities，PVH）和深部白质高信号（deep white matter hyperintensities，DWMH）分别评分，根据病灶数量评估LI的严重程度分析CMBs与PVH、DWMH及LI的关系。 　　结果随着PVH和DWMH评分的升高，CMBs的检出率分别由41.8%（PVH=1）及40.8%（DWMH=1）升高至68.8%（PVH=3）及76.9%（DWMH=3）；随着LI数量的增加，CMBs的检出率由46.3%升高至75%。深部CMBs与PVH及DWMH的严重程度有较强相关性（rs=0.345，P＜0.001；rs=0.346，P＜0.001），与LI亦显著相关（rs=0.281，P＜0.001）；而皮层CMBs与PVH及DWMH严重程度仅呈弱相关（rs=0.219，P=0.001；rs=0.189，P=0.005），与LI无显著相关性。 　　结论深部CMBs与脑室旁及深部脑白质病变、LI相关。
목적탐토뇌미출혈（cerebral microbleeds，CMBs）여뇌백질병변（white matter lesions，WML）급강극성경사（lacunar infarcts，LI）적관계。 　　방법련속납입2010년2월지2012년2월해방군총의원남루신경내과병방근거병사급두로영상학검사학진환유뇌혈관병혹구유고혈압、당뇨병、고지혈증등뇌혈관병위험인소자217례。채용G E공사1.5T자공진성상행두로상규서렬급T2*혈관가권성상（T2 star weighted angiography，SWAN）서렬소묘。기록심부급피층부위CMBs병조수，안조Fazekas평분화Scheltens개량량표장뇌실방백질고신호（peri-ventricular hyperintensities，PVH）화심부백질고신호（deep white matter hyperintensities，DWMH）분별평분，근거병조수량평고LI적엄중정도분석CMBs여PVH、DWMH급LI적관계。 　　결과수착PVH화DWMH평분적승고，CMBs적검출솔분별유41.8%（PVH=1）급40.8%（DWMH=1）승고지68.8%（PVH=3）급76.9%（DWMH=3）；수착LI수량적증가，CMBs적검출솔유46.3%승고지75%。심부CMBs여PVH급DWMH적엄중정도유교강상관성（rs=0.345，P＜0.001；rs=0.346，P＜0.001），여LI역현저상관（rs=0.281，P＜0.001）；이피층CMBs여PVH급DWMH엄중정도부정약상관（rs=0.219，P=0.001；rs=0.189，P=0.005），여LI무현저상관성。 　　결론심부CMBs여뇌실방급심부뇌백질병변、LI상관。
Objective To investigate the relationship between cerebral microbleeds(CMBs) and white matter lesions(WML) and lacunar infarcts(LI). Methods The identiifed population inculded 217 patients with cerebral vascular disease or related risk factors admitted to the Department of Geriatric Neurology of the PLA General Hospital between February, 2010 and February, 2012. Routine sequence and T2 star weighted angiography sequence of magnetic resonance imaging were performed with 1.5 Tesla machine maded by General Electric company. The number of CMBs in deep and cortical brain was record respectively. The peri-ventricular hyperintensities(PVH) and deep white matter hyperintensities(DWMH) were scored by Fazekas scale and modiifed rating scale reviesd by Scheltens. The severity of LI was classiifed by the number. Results As the score of PVH and DWMH increased, the detection rate of CMBs obviously increased from 41.8%and 40.8%in patient with the severity of PVH=1 and DWMH=1 to 68.8%and 76.9%in patient with the severity of PVH=3 and DWMH=3. The detection rate of CMBs also rised with the number of LI increasing. Deep CMBs were closely related to severity of peri-ventricular and deep WML (rs=0.345, P<0.001;rs=0.346, P<0.001), and were also related to LI (rs=0.281, P<0.001). Cortical CMBs were mildly related to severity of peri-ventricular WML and deep WML (rs=0.219, P=0.001;rs=0.189, P=0.005), and were not related to LI. Conclusion Deep cerebral microbleeds are obviously associated with peri-ventricular and deep white matter lesions and lacunar infarcts.