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目的脑萎缩和白质病变(WML)在老年人中常见,有共同危险因素,但不清楚两者是否相关。通过体积与视觉分级研究在深部和浅表结构上它们是否相关及呈何种程度的相关。方法测量颅内、总脑组织(TBV)、脑脊液(CSF)、脑室表面的蛛网膜下腔(SSS)、灰质、正常表现白质、WML的体积及CSF、静脉窦和硬脑膜的联合体积。以Fazekas量表对WML分级。结果 672位成年人[年龄(73±1)岁]中,WML与全脑萎缩(TBV,β=-0.43mm3,P<0.01)相关,特别与深部脑萎缩(脑室扩大,β=0.01mm3,P=0.03)而非浅表脑萎缩(SSS,β=0.09mm3,P=0.55)相关。WML体积增加1mm3,TVB相应减少0.43mm3,脑室体积增加0.10mm3。WLM与CSF+静脉窦+硬脑膜的联合体积相关,而非仅与CSF体积相关。一些相关性在校正血管危险因素后减弱。视觉评分WML的相关性类似。结论 WML与主要是深部脑结构的脑萎缩相关。评估脑缩小时,测量脑萎缩需包括所有颅内结构。要点①年龄增加有关的白质病变(WML)与脑萎缩轻度相关。②脑萎缩最相关的是深部结构(白质、基底节等)。③对WML无论测体积或视觉评分,结果均如此。④精确评价脑萎缩需评估所有颅内结构。
Aims Brain atrophy and white matter disease (WML) are common in the elderly with common risk factors, but it is unclear if they are related. Through the volume and visual classification of deep and superficial structure in the study of whether they are related and to what extent the correlation. Methods The intracranial, total brain tissue (TBV), cerebrospinal fluid (CSF), subarachnoid space (SSS), gray matter, normal white matter, WML volume and the combined volume of CSF, sinus and dura were measured. WML rating with Fazekas scale. Results WML was associated with atrophy of the whole brain (TBV, β = -0.43 mm3, P <0.01) in 672 adults [73 ± 1 years of age], particularly with deep brain atrophy (ventricular enlargement, β = 0.01 mm3, P = 0.03) rather than superficial atrophy (SSS, β = 0.09 mm3, P = 0.55). WML volume increased by 1mm3, TVB reduced by 0.43mm3, ventricular volume increased by 0.10mm3. WLM correlates with the combined volume of CSF + sinuses + dura, not just CSF volume. Some correlations are weakened after correcting for vascular risk factors. The visual score WML is similar in relevance. Conclusion WML is associated with brain atrophy, which is mainly deep brain structure. To assess brain shrinkage, all intracranial structures need to be included in measuring brain atrophy. Key points ① Age-related white matter lesions (WML) are slightly associated with brain atrophy. The most relevant brain atrophy is the deep structure (white matter, basal ganglia, etc.). ③ Regardless of the measured volume or visual score of WML, the result is the same. ④ Accurate evaluation of brain atrophy assessment of all intracranial structures.