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[Regional cerebral blood flow and periventricular hyperintensity in silent cerebral infarction--comparison with
Y Koshi1, S Kitamura, A Nagazumi
1Second Department of Internal Medicine, Nippon Medical School, First Hospital]
Abstract:
In order to investigate relationship between regional cerebral blood flow (rCBF) and the white matter lesions on MRI in silent cerebral infarction, we quantitatively measured rCBF by 123I-IMP autoradiography method (IMP ARG method) and single photon emission tomography (SPECT) in 36 patients with silent cerebral infarction (SCI group), 22 patients with multi-infarct dementia (MID group), and 16 control subjects without periventricular hyperintensity (PVH) and lacunar infarction on MRI (CL group). Regions of interest (ROIs) on rCBF images were set in the frontal (F), temporal (T), parietal (P), occipital (O) cortex, and the cerebral white matter (W). The severity of PVH on MRI T2-weighted image was divided into four grades (grade 0-3). Our results: 1) Though the frequency of hypertension was significantly higher in SCI group and MID group compared with CL group, no significant difference was seen in the mean age among these three groups. 2) rCBF in the white matter and cerebral cortices except the occipital cortex in SCI group was significantly low compared with CL group (gamma CBFSCI/gamma CBFCL: W 0.87, F 0.87, P 0.88, O 0.92). 3) rCBF in the white matter and cerebral cortices, especially in the white matter and frontal cortex, in MID group was significantly low compared with SCI group (gamma CBFMID/gamma CBFCL: W 0.69, F 0.71, T 0.74, P 0.75, O 0.81). 4) The mean grade of PVH in MID group was significantly higher that that in SCI group (SCI 1.1 vs MID 2.5). 5) The severity of PVH was significantly correlated with each rCBF in the white matter and cerebral cortices, especially in the white matter and frontal cortex. Our findings suggest that the quantitative measurement of rCBF by IMP ARG method is useful for the follow-up study in the patients with silent cerebral infarction as well as the evaluation of the severity of PVH on MRI.
Insights
Quantitative measurement of regional cerebral blood flow (rCBF) using the 123I-IMP autoradiography (ARG) method reveals reduced blood flow in silent cerebral infarction (SCI) and multi-infarct dementia (MID) patients. White matter lesion severity correlates with decreased rCBF, particularly in the frontal cortex.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Silent cerebral infarction (SCI) and multi-infarct dementia (MID) are associated with white matter lesions on MRI.
- Understanding the relationship between cerebral blood flow and these lesions is crucial for diagnosis and management.
Purpose of the Study:
- To investigate the relationship between regional cerebral blood flow (rCBF) and white matter lesions in patients with silent cerebral infarction (SCI) and multi-infarct dementia (MID).
- To evaluate the utility of the 123I-IMP autoradiography (ARG) method for assessing rCBF and periventricular hyperintensity (PVH) severity.
Main Methods:
- Quantitative measurement of rCBF using the 123I-IMP autoradiography (ARG) method and single-photon emission tomography (SPECT).
- Inclusion of 36 SCI patients, 22 MID patients, and 16 control subjects (CL).
- Assessment of white matter lesion severity (PVH) on MRI T2-weighted images (grades 0-3).
Main Results:
- Significantly lower rCBF in white matter and cerebral cortices (except occipital) in the SCI group compared to controls.
- Markedly reduced rCBF in white matter and frontal cortex in the MID group compared to both SCI and control groups.
- Higher PVH severity in MID patients than in SCI patients, with significant correlation between PVH severity and reduced rCBF in white matter and frontal cortex.
Conclusions:
- The 123I-IMP ARG method provides a quantitative measure of rCBF, useful for evaluating silent cerebral infarction and multi-infarct dementia.
- Reduced rCBF, particularly in the white matter and frontal regions, is associated with white matter lesion severity in these conditions.
- This quantitative rCBF measurement aids in follow-up studies and severity assessment of periventricular hyperintensity.