论文标题
衰老和疾病的脑血管形态 - 缺血性中风和阿尔茨海默氏病的生物标志物成像
Cerebrovascular morphology in aging and disease -- imaging biomarkers for ischemic stroke and Alzheimers disease
论文作者
论文摘要
背景和目的:改变的脑脉管系统是几种神经系统疾病的关键现象。本文对健康和患病的成年人的血管形态进行了定量评估,包括衰老期间的变化以及Willis圈(Cow)的解剖学变化。方法:我们使用自动方法从175名健康受试者,45位AIS和50名AD患者的MRA扫描中分割和提取脑脉管系统的新几何特征。接下来是对急性缺血性中风(AIS)和阿尔茨海默氏病(AD)的血管改变的定量和统计分析,这是最大的脑血管和神经退行性疾病。结果:我们确定只有35%的健康成年人完全形成了牛,并且发现曲折和分形显着提高,年龄增加,并且随着AIS和AD的疾病而增加。我们还发现,AIS患者的血管长度,体积和分支数量大大减少。最后,我们发现与年龄匹配的健康成年人相比,AD脑血管表现出明显较小的直径和更复杂的分支模式。随着AD从早期发作到中度重度痴呆的发展,这些变化显着提高。结论:AIS患者的血管几何形状变化表明,有病理形态和中风。在AD中,由于内皮的病理改变或淀粉样蛋白沉积导致神经元损伤和灌注不足,即使在轻度或早期痴呆症中,血管几何形状也会显着改变。特定的几何特征和定量比较表明,使用血管形态作为神经系统疾病的非侵入性成像生物标志物的潜力。
Background and Purpose: Altered brain vasculature is a key phenomenon in several neurologic disorders. This paper presents a quantitative assessment of vascular morphology in healthy and diseased adults including changes during aging and the anatomical variations in the Circle of Willis (CoW). Methods: We used our automatic method to segment and extract novel geometric features of the cerebral vasculature from MRA scans of 175 healthy subjects, 45 AIS, and 50 AD patients after spatial registration. This is followed by quantification and statistical analysis of vascular alterations in acute ischemic stroke (AIS) and Alzheimer's disease (AD), the biggest cerebrovascular and neurodegenerative disorders. Results: We determined that the CoW is fully formed in only 35 percent of healthy adults and found significantly increased tortuosity and fractality, with increasing age and with disease -- both AIS and AD. We also found significantly decreased vessel length, volume and number of branches in AIS patients. Lastly, we found that AD cerebral vessels exhibited significantly smaller diameter and more complex branching patterns, compared to age-matched healthy adults. These changes were significantly heightened with progression of AD from early onset to moderate-severe dementia. Conclusion: Altered vessel geometry in AIS patients shows that there is pathological morphology coupled with stroke. In AD due to pathological alterations in the endothelium or amyloid depositions leading to neuronal damage and hypoperfusion, vessel geometry is significantly altered even in mild or early dementia. The specific geometric features and quantitative comparisons demonstrate potential for using vascular morphology as a non-invasive imaging biomarker for neurologic disorders.