心脑血管疾病高危因素对脑铁沉积影响的磁共振影像学研究

doi:10.3785/j.issn.1008-9292.2019.12.09

浙江大学学报（医学版）

2019, Vol. 48

Issue (6): 644-650 DOI: 10.3785/j.issn.1008-9292.2019.12.09

原著

心脑血管疾病高危因素对脑铁沉积影响的磁共振影像学研究

胡琳琳^1,²(

),张睿婷¹,王淑玥¹,洪慧¹,黄沛钰^1,*(

),张敏鸣^1,*(

)

1. 浙江大学医学院附属第二医院放射科, 浙江杭州 310009
2. 金华市中心医院医学影像科, 浙江金华 321000

Correlation of cardiovascular risk factors with brain iron deposition: A magnetic resonance imaging study

HU Linlin^1,²(

),ZHANG Ruiting¹,WANG Shuyue¹,HONG Hui¹,HUANG Peiyu^1,*(

),ZHANG Minming^1,*(

)

1. Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
2. Department of Radiology, Jinhua Central Hospital, Jinhua 321000, Zhejiang Province, China

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摘要：

目的: 采用MRI方法研究常见心脑血管疾病高危因素与脑铁沉积的关系。方法: 纳入84名无神经系统疾病和脑外伤的社区中老年人，全面评估其心脑血管疾病高危因素，行MRI检查获取高清T1加权图像及T2^*加权三维梯度回波序列（ESWAN）图像，ESWAN图像后处理得R2^*图，采用计算机分割技术对高清T1加权图像进行组织分割，配准至ESWAN图像后，提取各脑区的R2^*值。采用多元线性回归分析揭示中老年人性别、年龄、心脑血管疾病高危因素对各脑区R2^*值的影响。结果: 海马、脑白质、脑皮质R2^*值升高与吸烟有关（β值分别为0.244、0.317、0.277，P < 0.05或P < 0.01）；壳核R2^*值升高与高血压有关（β值为0.241，P < 0.05）；丘脑R2^*值升高与高血糖有关（β值为0.234，P < 0.05）；男性丘脑R2^*值高于女性（β值为0.320，P < 0.05）；丘脑、尾状核、苍白球、脑白质、脑皮质等R2^*值与年龄相关（β值分别为-0.218、-0.254、0.216、-0.280和-0.238，P < 0.05或P < 0.01）。结论: 常见心脑血管疾病高危因素可能导致脑铁沉积，且不同因素引起的铁沉积模式不同。

关键词： 心血管疾病/病因学; 卒中/病因学; 危险因素; 铁/代谢; 磁共振成像

Abstract:

Objective: To study the correlation of common cardiovascular risk factors with brain iron deposition. Methods: Eighty-four elderly subjects without neurological diseases or brain trauma were included in the study. The cardiovascular risk factors were comprehensively assessed. MRI examination was performed to obtain high-resolution T1-weighted images and enhanced susceptibility weighted angiography (ESWAN) images, and R2^* figure was obtained by post-processing the ESWAN sequence. High definition T1 images were segmented using computer segmentation technique. After registration to the ESWAN image, R2^* values of each region of interest were extracted. Multiple linear regression analysis was used to analyze the relationship of R2^* values in each area of interest with gender, age and vascular risk factors. Results: Smoking was associated with increased R2^* values in the hippocampus, white matter and cortex (β=0.244, 0.317, 0.277, P < 0.05 or P < 0.01). Hypertension was correlated with the increase of R2^* in the putamen (β=0.241, P=0.027). Hyperglycemia was associated with the increase of R2^* in the thalamus (β=0.234, P < 0.05). In the thalamus, the R2^* value of males was higher than that of females (β=0.320, P < 0.05). Age was correlated with the R2^* values of thalamus, caudate nucleus, pallidus, white matter and cortex (β=-0.218、-0.254、0.216、-0.280 and -0.238, P < 0.05 or P < 0.01). Conclusion: Common cardiovascular risk factors may lead to iron deposition in the brain, and the deposition patterns vary with the gender, age and different risk factors.

Key words: Cardiovascular diseases/etiology Stroke/etiology Risk factors Iron/metabolism Magnetic resonance imaging

收稿日期: 2019-07-05 出版日期: 2020-01-19

R445.2

基金资助: 国家自然科学基金(81771820);浙江省自然科学基金(LSZ19H180001)

通讯作者: 黄沛钰,张敏鸣 E-mail: hu001987@163.com;huangpy@zju.edu.cn;zhangminming@zju.edu.cn

作者简介: 胡琳琳(1987-), 女, 硕士研究生, 主管技师, 主要从事磁共振影像学研究; E-mail:hu001987@163.com; https://orcid.org/0000-0002-1515-7161

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引用本文:

胡琳琳,张睿婷,王淑玥,洪慧,黄沛钰,张敏鸣. 心脑血管疾病高危因素对脑铁沉积影响的磁共振影像学研究[J]. 浙江大学学报（医学版）, 2019, 48(6): 644-650.

HU Linlin,ZHANG Ruiting,WANG Shuyue,HONG Hui,HUANG Peiyu,ZHANG Minming. Correlation of cardiovascular risk factors with brain iron deposition: A magnetic resonance imaging study. J Zhejiang Univ (Med Sci), 2019, 48(6): 644-650.

链接本文:

http://www.zjujournals.com/med/CN/10.3785/j.issn.1008-9292.2019.12.09 或 http://www.zjujournals.com/med/CN/Y2019/V48/I6/644

表 1 不同性别及有/无血管风险因素中老年人各脑区磁共振R2*值比较

表 2 社区中老年人各脑区磁共振R2*值与心脑血管疾病高危因素的回归分析结果

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