Purpose

To investigate cortical thickness and cortical quantitative T2 values as imaging markers of microstructural tissue damage in patients with unilateral high-grade internal carotid artery occlusive disease (ICAOD).

Methods

A total of 22 patients with ≥70% stenosis (mean age 64.8 years) and 20 older healthy control subjects (mean age 70.8 years) underwent structural magnetic resonance imaging (MRI) and high-resolution quantitative (q)T2 mapping. Generalized linear mixed models (GLMM) controlling for age and white matter lesion volume were employed to investigate the effect of ICAOD on imaging parameters of cortical microstructural integrity in multivariate analyses.

Results

There was a significant main effect (p < 0.05) of the group (patients/controls) on both cortical thickness and cortical qT2 values with cortical thinning and increased cortical qT2 in patients compared to controls, irrespective of the hemisphere. The presence of upstream carotid stenosis had a significant main effect on cortical qT2 values (p = 0.01) leading to increased qT2 in the poststenotic hemisphere, which was not found for cortical thickness. The GLMM showed that in general cortical thickness was decreased and cortical qT2 values were increased with increasing age (p < 0.05).

Conclusion

Unilateral high-grade carotid occlusive disease is associated with widespread cortical thinning and prolongation of cortical qT2, presumably reflecting hypoperfusion-related microstructural cortical damage similar to accelerated aging of the cerebral cortex. Cortical thinning and increase of cortical qT2 seem to reflect different aspects and different pathophysiological states of cortical degeneration. Quantitative T2 mapping might be a sensitive imaging biomarker for early cortical microstructural damage.

中文翻译：

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类似于颈动脉闭塞性疾病中大脑皮层加速老化的微观结构改变。

目的

研究皮质厚度和皮质定量 T2 值作为单侧高级别颈内动脉闭塞症 (ICAOD) 患者显微组织损伤的成像标志物。

方法

共有 22 名≥70% 狭窄患者（平均年龄 64.8 岁）和 20 名老年健康对照受试者（平均年龄 70.8 岁）接受了结构磁共振成像 (MRI) 和高分辨率定量 (q)T2 映射。采用控制年龄和白质病变体积的广义线性混合模型 (GLMM) 来研究 ICAOD 在多变量分析中对皮质微结构完整性成像参数的影响。

结果

 与对照组相比，组（患者/对照组）的皮质厚度和皮质 qT2 值具有显着的主效应（p < 0.05），与对照组相比，皮质变薄和皮质 qT2 增加，而与半球无关。上游颈动脉狭窄的存在对皮质 qT2 值有显着的主要影响 ( p  = 0.01)，导致狭窄后半球 qT2 增加，而皮质厚度未发现这种情况。GLMM 显示，一般来说，随着年龄的增长，皮质厚度减少，皮质 qT2 值增加（p  < 0.05）。

结论

单侧高级别颈动脉闭塞症与广泛的皮质变薄和皮质 qT2 延长有关，可能反映了与大脑皮质加速老化类似的低灌注相关的皮质微结构损伤。皮质变薄和皮质qT2增加似乎反映了皮质退行性变的不同方面和不同病理生理状态。定量 T2 映射可能是早期皮质微结构损伤的敏感成像生物标志物。