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Periventricular lucencies on computed tomography in multiple cerebral infarcts: correlation with cerebral blood flow
H Tachibana1, T Kaku, M Takeda
1Fifth Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
Insights
Periventricular lucencies (PVLs) significantly reduce cerebral blood flow (CBF) in patients with multiple cerebral infarcts. Severe PVLs showed the greatest impact on CBF, impacting cognitive function.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- Multiple cerebral infarcts are common in older adults.
- Periventricular lucencies (PVLs) are frequently observed on CT scans in these patients.
- The impact of PVLs on cerebral blood flow (CBF) requires further elucidation.
Purpose of the Study:
- To investigate the relationship between periventricular lucencies (PVLs) and cerebral blood flow (CBF) in patients with multiple cerebral infarcts.
- To assess the influence of PVL severity on CBF.
- To examine the correlation between CBF, PVLs, and cognitive status (dementia).
Main Methods:
- Study included 49 patients with multiple cerebral infarcts and 15 age-matched normal controls.
- Cerebral blood flow (CBF) was assessed using cortical blood flow (F1) values.
- Periventricular lucencies (PVLs) were graded (mild, moderate, severe) on CT scans.
Main Results:
- Patients with multiple cerebral infarcts had significantly lower mean F1 values than controls (p < .01).
- CBF (F1 values) decreased progressively with increasing PVL severity (p < .05 between severe and mild groups).
- Demented patients exhibited significantly lower F1 values compared to nondemented patients and normal subjects (p < .001).
Conclusions:
- Periventricular lucencies (PVLs), particularly severe ones, are associated with reduced cortical blood flow in patients with multiple cerebral infarcts.
- Reduced CBF may contribute to cognitive decline in this patient population.
- PVLs may play a role in the pathophysiology of cerebral hypoperfusion in patients with cerebrovascular disease.
Abstract:
Forty-nine patients with multiple cerebral infarcts with a mean age of 70.2 years were studied to elucidate the effect of periventricular lucencies (PVLs) on cerebral blood flow (CBF). Patients with multiple cerebral infarcts showed significantly lower mean cortical blood flow (F1) values compared to 15 age-matched normal subjects (p less than .01). The mean F1 values were most significantly decreased in severe group of PVLs and moderately decreased in moderate and mild groups (p less than .05 between severe and mild groups); however, no significant differences in mean F1 values were found between severe and moderate groups. Demented patients showed significantly lower F1 values compared to nondemented patients (p less than .001) and normal subjects (p less than .001). There was no significant difference in the degree of PVL between demented and nondemented groups. As well, the mean F1 values were not significantly correlated with either the number of infarcts or ventricular dilatation. These results suggest that PVLs on CT (especially in severe cases of PVLs) may have some role in the reduction of cortical blood flow in patients with multiple cerebral infarcts.