目的:颈动脉虹吸钙化可能通过增加动脉血流搏动而导致弹性假性黄瘤脑血管病的高患病率。本研究旨在比较颅内动脉血流搏动性,脑容量,弹性假性黄瘤患者与对照组之间的小血管疾病标志物以及弹性假性黄瘤的动脉钙化与搏动性之间的关联。
方法:50例弹性假性黄瘤患者和40例年龄和性别匹配的对照者接受了3TMR成像,包括用于评估脑容积的ICA和MCA以及FLAIR采集的流量脉动的2D相位对比采集,白质病变,和梗塞。所有弹性假性黄瘤患者均接受CT扫描以测量虹吸钙化。流量脉动性(2D相位对比),脑容量,白质病变,和梗死(3DT1和3DT2FLAIR)在患者和对照组之间进行比较。用线性回归模型检验了弹性假性黄瘤的虹吸钙化与搏动性之间的关系。
结果:弹性假性黄瘤患者(平均年龄,57[SD,12]年;24名男性)的搏动指数明显较高(1.05;范围,0.94-1.21对0.94;范围,0.82-1.04;P=.02),较低的平均GM体积(597[标准差,53]mL与632[SD,53]毫升;P<0.01),更多的白质病变(2.6;范围,0.5-7.5对1.1;范围,0.5-2.4)毫升;P=.05),和更多的腔隙性梗塞(64对8,P=.04)比对照组(平均年龄,58[SD,11]年;20人)。弹性假性黄瘤患者颈动脉虹吸钙化与较高的搏动指数相关(β=0.10;95%CI,0.01-0.18)。
结论:弹性假性黄色瘤患者颅内动脉血流搏动性增加,并有小血管病变的测量。颈动脉虹吸钙化可能是弹性假性黄瘤脑血管疾病患病率高的原因。
Carotid siphon calcification might contribute to the high prevalence of cerebrovascular disease in pseudoxanthoma elasticum through increased arterial flow pulsatility. This study aimed to compare intracranial artery flow pulsatility, brain volumes, and small-vessel disease markers between patients with pseudoxanthoma elasticum and controls and the association between arterial calcification and pulsatility in pseudoxanthoma elasticum.
Fifty patients with pseudoxanthoma elasticum and 40 age- and sex-matched controls underwent 3T MR imaging, including 2D phase-contrast acquisitions for flow pulsatility in the assessment of ICA and MCA and FLAIR acquisitions for brain volumes, white matter lesions, and infarctions. All patients with pseudoxanthoma elasticum underwent CT scanning to measure siphon calcification. Flow pulsatility (2D phase-contrast), brain volumes, white matter lesions, and infarctions (3D T1 and 3D T2 FLAIR) were compared between patients and controls. The association between siphon calcification and pulsatility in pseudoxanthoma elasticum was tested with linear regression models.
Patients with pseudoxanthoma elasticum (mean age, 57 [SD, 12] years; 24 men) had significantly higher pulsatility indexes (1.05; range, 0.94-1.21 versus 0.94; range, 0.82-1.04; P = .02), lower mean GM volumes (597 [SD, 53] mL versus 632 [SD, 53] mL; P < .01), more white matter lesions (2.6; range, 0.5-7.5 versus 1.1; range, 0.5-2.4) mL; P = .05), and more lacunar infarctions (64 versus 8, P = .04) than controls (mean age, 58 [SD, 11] years; 20 men). Carotid siphon calcification was associated with higher pulsatility indexes in patients with pseudoxanthoma elasticum (β = 0.10; 95% CI, 0.01-0.18).
Patients with pseudoxanthoma elasticum have increased intracranial artery flow pulsatility and measures of small-vessel disease. Carotid siphon calcification might underlie the high prevalence of cerebrovascular disease in pseudoxanthoma elasticum.