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【Brain】脑部炎症活动的MRI指标－血管周围间隙？
Perivascular spaces—MRI marker of inflammatory activity in the brain?
Correspondence to: Prof. Dr F. Zipp, Scientific Director of the Cecilie Vogt Clinic for Neurology in the HKBB, Charitéplatz 1, Charité – Universitaetsmedizin Berlin, 10117 Berlin, and Max-Delbrueck-Center for Molecular Medicine, Berlin, Germany E-mail: frauke.zipp@charite.de
The Virchow–Robin spaces (VRS), perivascular compartments surrounding small blood vessels as they penetrate the brain parenchyma, are increasingly recognized for their role in leucocyte trafficking as well as for their potential to modulate immune responses. In the present study, we investigated VRS numbers and volumes in different brain regions in 45 multiple sclerosis patients and 30 healthy controls of similar age and gender distribution, applying three different MRI sequence modalities (T2-weighted, T1-weighted and FLAIR). VRS were detected in comparable numbers in both multiple sclerosis patients and healthy individuals, indicating that perivascular compartments present on MRI are not a unique feature of multiple sclerosis. However, multiple sclerosis patients had significantly larger VRS volumes than healthy controls (P = 0.004). This finding was not explained by a significantly lower brain parenchymal fraction (BPF), resulting from a higher degree of atrophy, in the patient cohort. In a multiple linear regression analysis, age had a significant influence on VRS volumes in the control group but not in multiple sclerosis patients (P = 0.023 and P = 0.263, respectively). A subsequent prospective longitudinal substudy with monthly follow-up MRI over a period of up to 12 months in 18 patients revealed a significant increase in VRS volumes and counts accompanying the occurrence of contrast-enhancing lesions (CEL). At time points when blood–brain barrier (BB breakdown was indicated by the appearance of CEL, total VRS volumes and counts were significantly higher compared with preceding time points without CEL (P = 0.011 and P = 0.041, respectively), whereas a decrease thereafter was not statistically significant. Thus, our data points to an association of VRS with CEL as a sign for inflammation rather than with factors such as age, observed in healthy controls, and therefore suggests a role of VRS in inflammatory processes of the brain. 自己认领了......
题目：血管周围间隙－脑部炎症活动的MRI指标？
编译：Virchow–Robin间隙（VRS），即环绕在穿行于脑组织的小血管周围的腔隙。VRS在白细胞运输中发挥的作用以及其对免疫反应潜在的调节能力正逐步被认识。在本研究中，研究者利用3种不同的MRI序列（T2加权、T1加权FLAIR序列）扫描模式，对45例多发性硬化（MS）患者以及30例年龄、性别相匹配的对照者不同脑区VRS的数量和容积进行分析。MS患者和健康个体检出的VRS数量相当，说明MRI显示的血管周围腔隙不是MS的特征表现。但是，MS患者的VRS容积明显较健康个体增大（P＝0.004）。这一结果无法用MS患者组较高水平脑萎缩引起的脑实质分数（BPF）下降来解释。多元线性回归分析结果显示，对照组中受试者年龄明显影响VRS的容积，而在MS组却没有这种影响(P = 0.023 and P = 0.263)。后续的前瞻性队列研究对18例MS患者进行12月以上的MRI随访，每月进行一次MRI扫描。结果显示伴随着MRI强化病灶（CEL）的VRS容积和数量显著增加。当CEL现象所表示的血脑屏障破坏发生时，总的VRS容积和数量较CEL未出现时显著增加(P = 0.011 and P = 0.041)，而此后VRS的减少却没有统计学意义。因此，我们的研究数据显示VRS和MS患者CEL的伴发关系可以作为炎症反应的指标，并有理由认为VRS在脑炎症反应的过程中扮演重要角色，而在健康个体观察到的VRS和年龄之间的关系则不能作为一种指标。 [标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-04-30 05:14
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