摘要
目的:分析偏头痛患者与脑小血管病(cSVD)MRI表现及总负荷评分的相关性。方法:将2016年10月-2018年9月在本院神经内科诊断为偏头痛的69例患者及年龄和性别与患者组相匹配的从未发生过各种类型偏头痛的体检者69例(对照组)纳入研究。所有患者行多模态MRI(常规T1WI、T2WI、FLAIR、DWI和SWI),对每例患者的血管源性脑腔隙、白质内高信号(WMH)、微出血(CMBs)及血管周围间隙扩大(EPVS)这四个典型cSVD征象的出现情况及程度进行分析,并采用四级量表法进行总负荷评分。采用卡方检验比较两组受试者中cSVD征象出现率的差异,采用Mann-Whitney U检验比较两组间cSVD总负荷评分的差异,并采用二元Logistic回归法分析二者间的关系。结果:患者组和对照组中严重WMH(57.97%vs.40.58%;χ~2=4.175,P=0.041)和CMBs(28.99%vs.13.04%;χ~2=5.283;P=0.022)的出现率及cSVD总负荷评分(Z=-2.949;P=0.020)的差异有统计学意义。cSVD总负荷评分对偏头痛的诊断敏感度为59.42%,特异度为62.32%。校正混杂因素后的二元多变量回归分析显示,cSVD总负荷是偏头痛的独立危险因素(优势比=1.399,95%置信区间为1.036～1.890;P=0.029)。结论:偏头痛与cSVD的MRI表现密切相关,cSVD总负荷是偏头痛的独立危险因素。
Objective: To analyze the distribution of MRI features of cerebral small vessel disease (cSVD) and total MRI burden of cSVD in patients with migraine. Methods: Sixty-nine patients with migraine from the neurology department headache clinic of our hospital from October 2016 to September 2018 were collected as the migraine group,and sixty-nine healthy subjects who have never been any kind of migraine were used as the control group at the same time.The presence of lacunes,white matter hyperintensities (WMH),cerebral microbleeds (CMBs),enlarged perivascular spaces (EPVS) were recorded in an ordinal score (range 0~4).The difference of features of cSVD was conducted using Chi-squared test,the difference of distribution of total MRI burden of cSVD was conducted using Mann-Whitney U -test and the correlation between migraine and total MRI burden of cSVD was conducted using binary multivariate regression. Results: There was no statistical difference in age or sex between the two groups.There were significant differences in the proportions of severe WMH (57.97% vs. 40.58%;χ^ 2=4.175,P =0.041) and CMBs (28.99% vs. 13.04%;χ^ 2=5.283,P = 0.022) as well as total cSVD scores ( Z =-2.949,P =0.020) between the patients group and the control group.For the diagnosis of migraine,sensitivity of the total cSVD score on MRI was 59.42% and the specificity was 62.32%.After adjustment for confounding factors,binary multivariate regression analysis revealed that the total MRI burden score of cSVD (odds ratio:1.399,95% confidence interval:1.036~1.890,P =0.029) was the independent risk factor for migraine. Conclusion: The total MRI burden of cSVD is closely associated with the migraine and can be the independent risk factor of migraine.
作者
米荷音
李悦
郝咏刚
胡文立
MI He-ying;LI Yue;HAO Yong-gang(Department of Neurology,Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China)
出处
《放射学实践》
北大核心
2019年第4期386-391,共6页
Radiologic Practice
关键词
脑小血管病
偏头痛
磁共振成像
白质病变
脑微出血
血管周围间隙
Cerebral small vessel disease
Migraine
Magnetic resonance imaging
White matter disease
Cerebral microbleeds
Perivascular spaces
