Binswanger病における脳梁の変性と萎縮
Magnetization transfer(MT)法を用いてBinswanger病(BD)における脳梁の形態的特徴を明らかにし,大脳白質病変や知的機能障害との関連を検討した.BD群16例と健常老年者(C群)18例の脳梁面積を計測し,MTR{%,(Moff-Mon)×100/Moff;Moff,MonはMTパルス負荷前後の画像}を求め組織障害の程度の指標とした.BD群の脳梁面積は前部と後部で有意に小さく,特に前部はC群の約70%まで減少していた.MTRは前部,後部に加えて萎縮のみられない中部でも有意に低下し,髄鞘や軸索の変性,崩壊を含む組織学的変化が広範囲に生じていると考えられた.脳梁面積は近...
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| Published in | 脳卒中 Vol. 21; no. 3; pp. 297 - 302 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本脳卒中学会
1999
日本脳卒中学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0912-0726 1883-1923 |
| DOI | 10.3995/jstroke.21.297 |
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| Abstract | Magnetization transfer(MT)法を用いてBinswanger病(BD)における脳梁の形態的特徴を明らかにし,大脳白質病変や知的機能障害との関連を検討した.BD群16例と健常老年者(C群)18例の脳梁面積を計測し,MTR{%,(Moff-Mon)×100/Moff;Moff,MonはMTパルス負荷前後の画像}を求め組織障害の程度の指標とした.BD群の脳梁面積は前部と後部で有意に小さく,特に前部はC群の約70%まで減少していた.MTRは前部,後部に加えて萎縮のみられない中部でも有意に低下し,髄鞘や軸索の変性,崩壊を含む組織学的変化が広範囲に生じていると考えられた.脳梁面積は近接する大脳白質病変(PVH)のMTRと有意に相関し,PVH病変による二次的な軸索変性が脳梁の萎縮へ発展すると考えられた.また脳梁前部の面積やMTRと改訂長谷川式スコアとの問には有意な相関がみられ,前頭葉白質病変と関連した脳梁前部の組織傷害が知的機能障害の発現に関連していることが示唆された. |
|---|---|
| AbstractList | Magnetization transfer(MT)法を用いてBinswanger病(BD)における脳梁の形態的特徴を明らかにし,大脳白質病変や知的機能障害との関連を検討した.BD群16例と健常老年者(C群)18例の脳梁面積を計測し,MTR{%,(Moff-Mon)×100/Moff;Moff,MonはMTパルス負荷前後の画像}を求め組織障害の程度の指標とした.BD群の脳梁面積は前部と後部で有意に小さく,特に前部はC群の約70%まで減少していた.MTRは前部,後部に加えて萎縮のみられない中部でも有意に低下し,髄鞘や軸索の変性,崩壊を含む組織学的変化が広範囲に生じていると考えられた.脳梁面積は近接する大脳白質病変(PVH)のMTRと有意に相関し,PVH病変による二次的な軸索変性が脳梁の萎縮へ発展すると考えられた.また脳梁前部の面積やMTRと改訂長谷川式スコアとの問には有意な相関がみられ,前頭葉白質病変と関連した脳梁前部の組織傷害が知的機能障害の発現に関連していることが示唆された. Magnetization transfer(MT)法を用いてBinswanger病(BD)における脳梁の形態的特徴を明らかにし, 大脳白質病変や知的機能障害との関連を検討した. BD群16例と健常老年者(C群)18例の脳梁面積を計測し, MTR{％, (Moff-Mon)×100/Moff;Moff, MonはMTパルス負荷前後の画像}を求め組織障害の程度の指標とした. BD群の脳梁面積は前部と後部で有意に小さく, 特に前部はC群の約70％まで減少していた. MTRは前部, 後部に加えて萎縮のみられない中部でも有意に低下し, 髄鞘や軸索の変性, 崩壊を含む組織学的変化が広範囲に生じていると考えられた. 脳梁面積は近接する大脳白質病変(PVH)のMTRと有意に相関し, PVH病変による二次的な軸索変性が脳梁の萎縮へ発展すると考えられた. また脳梁前部の面積やMTRと改訂長谷川式スコアとの間には有意な相関がみられ, 前頭葉白質病変と関連した脳梁前部の組織傷害が知的機能障害の発現に関連していることが示唆された. |
| Author | 岩本, 俊彦 羽生, 春夫 浅野, 哲一 櫻井, 博文 高崎, 優 |
| Author_FL | ASANO Tetsuichi IWAMOTO Toshihiko TAKASAKI Masaru SAKURAI Hirofumi HANYU Haruo |
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| DocumentTitleAlternate | Degeneration and atrophy of the corpus callosum in patients with Binswanger's disease |
| DocumentTitle_FL | Degeneration and atrophy of the corpus callosum in patients with Binswanger's disease |
| EISSN | 1883-1923 |
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| References | 19) Hampel H, Teipel SJ, Alexander GE, et al: Corpus callosum atrophy is a possible indicator of region-and cell type-specific neuronal degeneration in Al-zheimer disease. A magnetic resonance imaging analysis. Arch Neurol 55: 193—198,1998 4) Lyoo IK, Satlin A, Lee CK, et al: Regional atrophy of the corpus callosum in subjects with Al-zheimer's disease and multi-infarct dementia. Psychiatry Res 74: 63—72,1997 6) American Psychiatric Association: Diagnostic and statistical manual of mental disorders. 3 rd ed Revised. Washington DC, American Psychiatric Assoc, 1987, pp 103—123 7) Bennett DA, Wilson RS, Gilley DW, et al: Clinical diagnosis of Binswanger's disease. J Neurol Neu-rosurg Psychiatry 53: 961—965,1990 12) Balaban RS, Ceckler TL: Magnetization transfer contrast in magnetic resonance imaging. Magn Reson Q8: 116—137,1992 10) 井門ゆかり,羽生春夫,岩本俊彦ら:アルツハイマー病における脳梁の萎縮とmagnetization transfer ratio.臨床神経38:1014―1018,1998 9) 羽生春夫,井門ゆかり,浅野哲一ら:Magnetization transfer contrast画像による多発梗塞性痴呆における大脳白質病変の病態に関する検討.臨床神経38:412―417,1998 13) Dousset V, Grossman RI, Ramer KN, et al: Experimental allergic encephalomyelitis and multiple sclerosis: lesion characterization with magnetization transfer imaging. Radiology 182: 483—491,1992 24) Chimowitz MI, Estes ML, Furlan AJ, et al: Further observations on the pathology of subcortical lesions identified on magnetic resonance imaging. Arch Neurol 49: 747—752,1992 14) Mehta RC, Pike B, Enzmann DR: Measure of magnetization transfer in multiple sclerosis de-myelinating plaques, white matter ischemic le-sions, and edema. Am J Neuroradiol 17:1051—1055,1996 15) Hanyu H, Asano T, Sakurai H, et al: Magnetization transfer ratio in cerebral white matter lesions of Binswanger's disease. J Neurol Sci 166: 85—90, 1999 25) Fazekas F, Kleinert R, Offenbaucher H, et al: Pathologic correlates of incidental MRI white matter signal hyperintensities. Neurology 43: 1683—1689,1993 2) Moody DM, Bell MA, Challa VR: The corpus cal-losum, a unique white matter tract: anatomic fea-tures that may explain sparing in Binswanger disease and resistance to flow of fluid masses. Am J Neuroradiol 9:1051—1059,1988 23) Leifer D, Buonanno FS, Richardson Jr EP: Clinicopathologic correlations of cranial magnetic reso-nance imaging of periventricular white matter. Neurology 40: 911—918,1990 1) Caplan LR: Binswanger's disease-revisited. Neurology 45: 626—633, 1995 21) 羽生春夫,新藤博明,柿崎大ら:拡散強調画像によるBinswanger病の大脳白質病変の検討.臨床神経36:442―450,1996 17) 吉井文均,Duara R:健常者およびアルツハイマー病患者の脳梁の大きさについて―磁気共鳴画像法による検討―.臨床神経29:1―7,1989 22) Sze G, De Armond SJ, Brant-Zawadzki M, et al: Foci of MRI signal (pseudolesions) anterior to the frontal horns: histologic correlations of a normal finding. Am J Neuroradiol 7: 381—387, 1986 16) Hanyu H, Imon Y, Sakurai H, et al: Diffusion-weighted magnetic resonance and magnetization transfer imaging in the assessment of ischemic human stroke. Internal Medicine 37:360—365, 1998 5) Fazekas F, Chawluk JB, Alavi A, et al: MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging. Am J Neuroradiol 149: 351—356,1987 18) Yamauchi H, Fukuyama H, Harada K, et al: Cal-losal atrophy parallels decreased cortical oxygen metabolism and neuropsychological impairment in Alzheimer's disease. Arch Neurol 50: 1070—1074,1993 20) Yamanouchi H, Sugiwara S, Shimada H: Loss of nerve fibers in the corpus callosum of progressive subcortical vascular encephalopathy. J Neurol 237: 39—41,1990 3) Yamauchi H, Fukuyama H, Ogawa M, et al: Cal-losal atrophy in patients with lacunar infarction and extensive leukoaraiosis. An indicator of cognitive impairement. Stroke 25: 1788—1793, 1994 11) Wolff SD, Balaban RS: Magnetization transfer contrast (MTC) and tissue water proton relaxation in vivo. Magn Reson Med 10: 135—144,1989 8) Hachinski VC, lliff LD, Zilhka E, et al: Cerebral blood flow in dementia. Arch Neurol 32: 632—637, 1975 |
| References_xml | – reference: 21) 羽生春夫,新藤博明,柿崎大ら:拡散強調画像によるBinswanger病の大脳白質病変の検討.臨床神経36:442―450,1996 – reference: 5) Fazekas F, Chawluk JB, Alavi A, et al: MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging. Am J Neuroradiol 149: 351—356,1987 – reference: 14) Mehta RC, Pike B, Enzmann DR: Measure of magnetization transfer in multiple sclerosis de-myelinating plaques, white matter ischemic le-sions, and edema. Am J Neuroradiol 17:1051—1055,1996 – reference: 12) Balaban RS, Ceckler TL: Magnetization transfer contrast in magnetic resonance imaging. Magn Reson Q8: 116—137,1992 – reference: 15) Hanyu H, Asano T, Sakurai H, et al: Magnetization transfer ratio in cerebral white matter lesions of Binswanger's disease. J Neurol Sci 166: 85—90, 1999 – reference: 19) Hampel H, Teipel SJ, Alexander GE, et al: Corpus callosum atrophy is a possible indicator of region-and cell type-specific neuronal degeneration in Al-zheimer disease. A magnetic resonance imaging analysis. Arch Neurol 55: 193—198,1998 – reference: 9) 羽生春夫,井門ゆかり,浅野哲一ら:Magnetization transfer contrast画像による多発梗塞性痴呆における大脳白質病変の病態に関する検討.臨床神経38:412―417,1998 – reference: 1) Caplan LR: Binswanger's disease-revisited. Neurology 45: 626—633, 1995 – reference: 25) Fazekas F, Kleinert R, Offenbaucher H, et al: Pathologic correlates of incidental MRI white matter signal hyperintensities. Neurology 43: 1683—1689,1993 – reference: 13) Dousset V, Grossman RI, Ramer KN, et al: Experimental allergic encephalomyelitis and multiple sclerosis: lesion characterization with magnetization transfer imaging. Radiology 182: 483—491,1992 – reference: 17) 吉井文均,Duara R:健常者およびアルツハイマー病患者の脳梁の大きさについて―磁気共鳴画像法による検討―.臨床神経29:1―7,1989 – reference: 4) Lyoo IK, Satlin A, Lee CK, et al: Regional atrophy of the corpus callosum in subjects with Al-zheimer's disease and multi-infarct dementia. Psychiatry Res 74: 63—72,1997 – reference: 18) Yamauchi H, Fukuyama H, Harada K, et al: Cal-losal atrophy parallels decreased cortical oxygen metabolism and neuropsychological impairment in Alzheimer's disease. Arch Neurol 50: 1070—1074,1993 – reference: 10) 井門ゆかり,羽生春夫,岩本俊彦ら:アルツハイマー病における脳梁の萎縮とmagnetization transfer ratio.臨床神経38:1014―1018,1998 – reference: 24) Chimowitz MI, Estes ML, Furlan AJ, et al: Further observations on the pathology of subcortical lesions identified on magnetic resonance imaging. Arch Neurol 49: 747—752,1992 – reference: 22) Sze G, De Armond SJ, Brant-Zawadzki M, et al: Foci of MRI signal (pseudolesions) anterior to the frontal horns: histologic correlations of a normal finding. Am J Neuroradiol 7: 381—387, 1986 – reference: 3) Yamauchi H, Fukuyama H, Ogawa M, et al: Cal-losal atrophy in patients with lacunar infarction and extensive leukoaraiosis. An indicator of cognitive impairement. Stroke 25: 1788—1793, 1994 – reference: 16) Hanyu H, Imon Y, Sakurai H, et al: Diffusion-weighted magnetic resonance and magnetization transfer imaging in the assessment of ischemic human stroke. Internal Medicine 37:360—365, 1998 – reference: 23) Leifer D, Buonanno FS, Richardson Jr EP: Clinicopathologic correlations of cranial magnetic reso-nance imaging of periventricular white matter. Neurology 40: 911—918,1990 – reference: 2) Moody DM, Bell MA, Challa VR: The corpus cal-losum, a unique white matter tract: anatomic fea-tures that may explain sparing in Binswanger disease and resistance to flow of fluid masses. Am J Neuroradiol 9:1051—1059,1988 – reference: 11) Wolff SD, Balaban RS: Magnetization transfer contrast (MTC) and tissue water proton relaxation in vivo. Magn Reson Med 10: 135—144,1989 – reference: 8) Hachinski VC, lliff LD, Zilhka E, et al: Cerebral blood flow in dementia. Arch Neurol 32: 632—637, 1975 – reference: 6) American Psychiatric Association: Diagnostic and statistical manual of mental disorders. 3 rd ed Revised. Washington DC, American Psychiatric Assoc, 1987, pp 103—123 – reference: 7) Bennett DA, Wilson RS, Gilley DW, et al: Clinical diagnosis of Binswanger's disease. J Neurol Neu-rosurg Psychiatry 53: 961—965,1990 – reference: 20) Yamanouchi H, Sugiwara S, Shimada H: Loss of nerve fibers in the corpus callosum of progressive subcortical vascular encephalopathy. J Neurol 237: 39—41,1990 |
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| Snippet | Magnetization transfer(MT)法を用いてBinswanger病(BD)における脳梁の形態的特徴を明らかにし,大脳白質病変や知的機能障害との関連を検討した.BD群16例と健常老年者(C... Magnetization transfer(MT)法を用いてBinswanger病(BD)における脳梁の形態的特徴を明らかにし, 大脳白質病変や知的機能障害との関連を検討した. BD群16例と健常老年者(C... |
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| SubjectTerms | atrophy BInswanger's disease cropus callosum degeneration magnetization transfer ratio |
| Title | Binswanger病における脳梁の変性と萎縮 |
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