鼻窦粘膜增厚,在磁共振成像(MRI)中可见,可能是微血管炎症的来源,但其与小血管病(SVD)的关系尚不清楚。我们回顾了文献并分析了散发性SVD患者的样本,以确定鼻旁窦混浊严重程度与SVD神经影像学标记之间的任何关联。
我们系统回顾了截至2020年4月的MEDLINE和EMBASE数据库,以研究SVD患者的鼻窦粘膜变化。脑血管疾病(CVD),和年龄相关的神经退行性疾病。我们在一项前瞻性研究中分析了100名参与者的临床和MRI数据,轻度卒中研究3(ISRCTN12113543)在轻微卒中后1-3,6和12个月时从文献综述中检验关键结局.我们使用多元线性回归来探索改良的Lund-Mackay(LM)评分与大脑之间的关联,白质高强度(WMH),在每个时间点增大的血管周围空间(PVS)体积,调整基线年龄,性别,糖尿病,高胆固醇血症,高血压和吸烟。
文献综述,在筛选3652种出版物后,产生了11项主要研究,对于具有矛盾结果的定性综合,因为5/7CVD研究的正相关/高风险与样本最大的两项研究相矛盾,来自痴呆症研究的数据在结果上平均分配。从所分析的患者的试点样本中(女性N=33,平均年龄67.42(9.70)岁),在基线和6个月时,LM总评分与半卵中心PVS呈临界负相关(B=-0.25,SE=0.14,p=0.06),但与平均脑组织无关。WMH或正常出现的白质体积。
文献综述和实证研究的不确定结果证明了在散发性SVD患者中PVS体积和鼻旁窦混浊之间的更大研究。
The paranasal sinus mucosal thickening, visible in magnetic resonance imaging (MRI), maybe a source of inflammation in microvessels, but its relationship with small vessel disease (SVD) is unclear. We reviewed the literature and analysed a sample of patients with sporadic SVD to identify any association between paranasal sinus opacification severity and SVD neuroimaging markers.
We systematically reviewed MEDLINE and EMBASE databases up to April 2020 for studies on paranasal sinus mucosal changes in patients with SVD, cerebrovascular disease (CVD), and age-related neurodegenerative diseases. We analysed clinical and MRI data from 100 participants in a prospective study, the Mild Stroke Study 3 (ISRCTN 12113543) at 1-3, 6 and 12 months following a minor stroke to test key outcomes from the literature review. We used multivariate linear regression to explore associations between modified Lund-Mackay (LM) scores and brain, white matter hyperintensities (WMH), enlarged perivascular spaces (PVS) volumes at each time point, adjusted for baseline age, sex, diabetes, hypercholesterolaemia, hypertension and smoking.
The literature review, after screening 3652 publications, yielded 11 primary studies, for qualitative synthesis with contradictory results, as positive associations/higher risk from 5/7 CVD studies were contradicted by the two studies with largest samples, and data from dementia studies was equally split in their outcome. From the pilot sample of patients analysed (female N = 33, mean age 67.42 (9.70) years), total LM scores had a borderline negative association with PVS in the centrum semiovale at baseline and 6 months (B = -0.25, SE = 0.14, p = 0.06) but were not associated with average brain tissue, WMH or normal-appearing white matter volumes.
The inconclusive results from the literature review and empirical study justify larger studies between PVS volume and paranasal sinuses opacification in patients with sporadic SVD.