321/321L Stainless simbi capillary tube Association yewhite matter hyperintensity ine coronary artery calcification muvanhu vane hutano: chidzidzo chemuchinjika.

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White matter hyperintensity (WWH) inowanzowanikwa pamagnetic resonance imaging (MRI) yeuropi uye inozivikanwa kuratidza chirwere chidiki chemidziyo muuropi.Chinangwa chechidzidzo chedu chaiva chekuongorora kushamwaridzana kwecoronary artery calcium (CCA) neWMH uye kujekesa hukama huri pakati peWMH uye zvinokonzera njodzi yeatherosclerosis muhuwandu hwevanhu vane hutano.Ichi chidzidzo chekudzoka zvakare chaisanganisira vanhu 1337 vakaita uropi MRI uye computed tomography neCAC kuongorora pachipatara chepamusoro chechipatara.Iyo GVM yeuropi yakatsanangurwa seFazekas mamakisi anopfuura maviri mapoinzi paMRI yehuropi.Intracranial arterial stenosis (ICAS) yakaongororwawo uye yakasimbiswa apo angiography yakaratidza kupfuura 50% stenosis.Kushamwaridzana kwezvipingamupinyi, CAC uye ICAS zvibodzwa nehuropi HBG zvakaongororwa uchishandisa multivariate regression analysis.Mukuongorora kwakasiyana-siyana, mapoka ane zvikwata zvepamusoro zveCAC zvakaratidza kuwedzera kushamwaridzana ne periventricular uye yakadzika hypertension mune imwe nzira-inotenderera.Kuvapo kweICAS kwaibatanidzwawo zvakanyanya nehuropi HBH, uye pakati pemakiriniki akasiyana, zera uye hypertension zvaive zvakazvimirira zvengozi.Mukupedzisa, muhuwandu hwevanhu vane hutano, CAC yaive yakabatana zvakanyanya nehuropi WMH, iyo inogona kupa humbowo hwekuziva vanhu vari panjodzi yehuropi WMH maererano neCAC mamakisi.

Stainless Simbi 321 Coil Tube Chemical Kuumbwa

Iko kemikari ye321 simbi isina tsvina coil tubing ndeiyi inotevera:
- Carbon: 0.08% max
- Manganese: 2.00% max
Nickel: 9.00% min

321/321L simbi isina tsvina 8 * 0.2 capillary chubhu

Stainless Simbi 321 Coil Tube Mechanical Properties

321/321L simbi isina tsvina 8 * 0.2 capillary chubhu

Zvinoenderana neStainless Steel 321 Coil Tube Manufacturer, iyo mechaniki yesimbi isina tsvina 321 coil tubing yakanyorwa pazasi: Tensile Simba (psi) Goho Simba (psi) Elongation (%).

321/321L simbi isina tsvina 8 * 0.2 capillary chubhu

White matter hyperintensity (WWH) inowanzowanikwa muT2-inorema uye fluid-attenuated magnetic resonance imaging (MRI) inversion recovery (FLAIR) sequences yeuropi1,2.Kunyange zvazvo iyo chaiyo pathophysiological mechanism yeHHH isingazivikanwi, yakaratidza kuti inobatanidzwa nehutachiona hwehutachiona hwehutachiona hwakadai sekukwegura, hypertension, chirwere cheshuga, kusvuta, uye kufutisa, zvichiratidza kugovera kwemaitiro evascular pakukura kweHHH3,4,5 ,6.,7,8,9,10.Zvidzidzo zvepathological zvakaratidzawo kuti HHH inokonzerwa nekushaya simba kwevascular integrity, nokudaro kusimbisa kuti HHH inoratidzira chirwere chiduku chemidziyo muuropi11.Mukuwedzera, SHG yakakosha kuchipatara sezvo yakaratidza kukanganisa kuitika uye kufungidzira kwehutano hwakasiyana-siyana hwehutano, kusanganisira kuderera kwekuziva, kuora mwoyo, kuora mwoyo, gait disturbance, uye sitiroko12,13,14,15,16,17,18, 19 , 20, 21, 22, 23.
Coronary calcium assessment (CAC) inoonekwa seyakanakira uye yakavimbika chiyero chekuwedzera kwemunhu kune atherosclerosis uye yakaratidza kuve yakabatana ne ischemic sitiroko uye cranial artery stenosis, pamwe ne coronary heart disease24,25.Diki cerebral mudziyo chirwere chinogara pamwe chete neatherosclerosis yetsinga hombe intracranial nekuti midziyo midiki inoputika inopa zvinhu chena inotangira kubva kune hombe basilar artery.Zvidzidzo zvakawanda zvakaratidza kushamwaridzana pakati peSHH uye njodzi dzeatherosclerosis kana carotid atherosclerosis, zvisinei, zvidzidzo zvishomanana chete zvakatarisa hukama pakati peSAS mutoro neSHH, uye zvidzidzo izvi zvakangoitwa muvakuru vakuru kana varume 29, 30, 31 .32.
Nekuwedzera kwekuwanikwa kweurouroimaging mumakore achangopfuura, kuwanda kwepamusoro uye kukosha kwekliniki yeHHH kunowedzera kuzivikanwa sechinhu chinofanotaura nezvekuderera kwekuziva uye sitiroko mhedzisiro19,20,21,22,23.Kukurudzira kwechidzidzo ichi kwaiva kuti kana chikwata cheCAC chaigona kushandiswa mumakiriniki ekudzidzira kufanotaura njodzi yeSHH, chirevo chezvirwere zvakasiyana-siyana zvetsinga, inogona kunge iri chinhu chakanaka uye chinobatsira chekuziva kubatsirwa kunobvira kwezvimwe zvidzidzo zvevanhu, zvakadai. seMRI yeuropi19,20,21,22,23.Isu takafungidzira kuti HHH yakabatana zvakanyanya neCCA mutoro, chiratidzo cheatherosclerosis, munhamba huru yevanhu vane hutano muhuwandu hwevanhu.Pamusoro pezvo, takatsvaga kubatsira kunzwisisa nzira dziri pasi pekuvandudzwa kweHHH nekuona zvakakosha zvengozi yekiriniki.Nokudaro, chinangwa chikuru chechidzidzo ichi chaiva chekuongorora kushamwaridzana kweCAC neWMH muhuwandu hwevanhu vane hutano.Chechipiri, chinangwa chechidzidzo ichi chaive chekujekesa hukama pakati peSHG uye njodzi dzeatherosclerosis.
Ichi chidzidzo chidzidzo chemuchinjika chemashure chinoenderana neruzhinji rwevanhu.Takatsvaga magwaro emagetsi evatori vechikamu vakaongororwa zvekurapa, kusanganisira brain MRI uye magnetic resonance angiography (MRA), paGangbuk Samsung Hospital General Medical Centers muSeoul neSuwon pakati paNdira 2016 naZvita 2019. Huwandu hwevanhu hwaisanganisira zvidzidzo zvakaitwa neCAC computed tomography ( CT) uye kufungidzira kwehuropi sechikamu chekuongororwa kwemuviri kwakadzama, idzo dzakajairika nzira dzekuongorora hutano muKorea.Zvekureva, mutemo weKorea unoda kuti vashandi vese vatariswe gore rega rega kana makore maviri ekurapa, saka vatori vechikamu vazhinji vashandi kana nhengo dzemhuri dzevashandi vemakambani akasiyana kana masangano ehurumende.
Pakati pevanhu ve3983, 2646 yakanga isingabatanidzwi nokuda kwezvikonzero zvinotevera: a) kusabvumirana nekushandiswa kwemashoko ezvokurapa kune chero chinangwa chekutsvakurudza mumubvunzo wega wega usati waongororwa (n = 376);kana kudzokorora miedzo yakaitwa panguva (n = 43), vanhu vane kudzokorora bvunzo havana kubatanidzwa, uye CT uye uropi hwekufungidzira neCAC ongororo yakaitwa pazuva rimwechete kana panguva ichangopfuura nguva yenguva yakasarudzwa yekudzidza;(c) inozivikanwa dementia, chirwere cheParkinson.nhoroondo, hydrocephalus, kuvhiyiwa kwehuropi kwekare, bundu reuropi, chirwere che moyamoya, sitiroko kana kubuda ropa (n = 47);(d) vanhu vane maronda akakosha europi anoonekwa nekuongorora kwechifananidzo, semuenzaniso, nekuda kwekutanga encephalomalacia nekuda kwesitiroko (yakakura dhayamita chiyero chikuru kupfuura 15 mm) kana yekare inoshungurudza hemorrhage, arteriovenous malformation, kana neoplastic lesion (n = 46);(e) vanhu vane MRI kana MRA yehutano husina kukwana hwekuongorora mufananidzo (n = 2);(f) vanhu vasina kuita CT pachiyero cheCAC (n = 1796);(g) vanhu vasina nhamba yedata inodiwa kuongororwa, kusanganisira body mass index (BMI) uye homocysteine ​​​​mazinga (n = 336).Rondedzero yekutora vatori vechikamu chidzidzo inoratidzwa muMufananidzo 1.
Sanganisira hurongwa hwevatori vechikamu.MRI magnetic resonance imaging, MRA magnetic resonance angiography, periventricular white matter hyperintensity PVWMH, deep white matter hyperintensity
Nokudaro, zvidzidzo zve1337 (kureva makore 51.63 ± 9.20 makore, makore ezera 20-89 makore, 1157 [86.54%] varume varwere) vakabatanidzwa muchidzidzo ichi.Vese vatori vechikamu vakadzokororwa vakaongororwa zvekiriniki uye radiographic zvakawanikwa.Ichi chidzidzo chakaitwa maererano nemitemo yeDeclaration yeHelsinki uye yakagamuchirwa neInstitutional Review Board (IRB) yeGangbuk Samsung Hospital (IRB No. 2020-12-036-006).Iyo IRB paKangbuk Samsung Hospital yakaregedza chibvumirano cheruzivo nekuda kwekushandiswa kwedata risingazivikanwe uye dhizaini yekudzidza.Nzira dzose dzekutsvakurudza dzakaitwa maererano nemitemo yakakodzera uye mitemo.
Takaunganidza dhata rekiriniki rega rega rinosanganisira murume kana mukadzi, zera, BMI, systolic uye diastolic blood pressure, nhoroondo yekusvuta, kurovedza muviri, uye kuongororwa uye kurapwa kwehypertension, chirwere cheshuga, hyperlipidemia, uye chirwere chemoyo.Kubva mugwaro remibvunzo anozvisarudzira ega, takaunganidza ruzivo rwenhoroondo yezvehutano yemunhu wega wega uye nhoroondo yekuputa, pamwe nekuti vaigara vachiita kurovedza muviri kwakasimba kweanopfuura maminitsi gumi kanenge katatu pasvondo.
Nekuti vese vatori vechikamu vakarongwa kuti vaongororwe kuGanbuk Samsung Hospital General Medical Center, bvunzo dzemurabhoritari dzakaitwa pazuva rimwechete seMRI yeuropi uye MRA mushure mekutsanya kweawa gumi nemaviri, uye data yaisanganisira glucose, glycated hemoglobin (HbA1c), mazinga. yecholesterol yakazara, LDL cholesterol, HDL cholesterol, triglycerides uye homocysteine.
Arterial hypertension yakatsanangurwa semazuva ano kutora kwemishonga inorwisa-hypertensive, systolic blood pressure ≥ 140 mmHg.kana diastolic blood pressure ≥ 90 mmHg33.Chirwere cheshuga chaitsanangurwa seyazvino antidiabetic kushandiswa kwezvinodhaka, kutsanya ropa glucose ≥ 126 mg / dL, kana HbA1c ≥ 6.5%.Dyslipidaemia yakatsanangurwa sekushandiswa kwemazuva ano kwemishonga inoderedza lipid, yakazara cholesterol ≥240 mg / dl, yakaderera-density lipoprotein cholesterol ≥160 mg / dl, high-density lipoprotein cholesterol <40 mg / dl, kana triglycerides ≥200 mg / dl35.
Vese vatori vechikamu vakawana MRI yehuropi uye MRA ine sere-channel head coil vachishandisa 1.5 T MRI scanner (Optima MR360, GE Healthcare, Milwaukee, Wisconsin kana Signa HDxt, GE Healthcare, Milwaukee, Wisconsin).Iyo yekufungidzira protocol yaive neaxial T1-inorema mifananidzo (inodzokororwa nguva [TR]/echo nguva [TE] = 417–450/9 ms kana 400–450/10 ms), T2-yakayerwa mifananidzo (TR/TE = 4343–4694 ) ./100-110 ms kana 4084-4494/95-104 ms), FLAIR mifananidzo (TR/TE = 11000/127-138 ms kana 8800/128-130 ms) uye 3D nguva-ye-ndege (TOF) mifananidzo (TR /TE = 28/7 ms kana 27/3 ms, chidimbu chakakora = 1.2 mm).Ukobvu hwechidimbu hwaive 5 mm kune ese maprotocol ekufungidzira kunze kweTOF MRA.
Dhigirii re periventricular uye yakadzika WMH yakaongororwa zvakasiyana zvichienderana nechidzidzo chega chega Fazekas scale1, sezvakaratidzwa muSupplementary Figure 1 online.PVWMH yakawana sezvizvi: 0=hapana, 1=chivharo kana kuti lining yakatetepa, 2=smooth halo, 3=isingaenzaniswi periventricular hyperintensity ichipinda muchinhu chena chakadzika.DMH inorongedzerwa sezvizvi: 0 = asipo, 1 = punctate, 2 = maronda anotanga kubatana, 3 = nzvimbo huru dzekusangana.Nekuda kwekuti huropi HBH giredhi 2 kana yepamusoro hunozivikanwa kuve hwakakosha kuchipatara nekuti hunowanzoita zviratidzo uye kufambira mberi, takapatsanura varwere vane Fazekas zvibodzwa zve2 ne3 kuita PVBVH neDGBV36,37.
Ongororo yeTOF MRA, yakavakirwa panzira yewarfarin-aspirin symptomatic intracranial disease (WASID), inotsanangura intracranial artery stenosis (ICAS) seine intracranial artery stenosis inopfuura 50% 38.Midziyo yakabatanidzwa mukuongororwa yaiva yemukati ye carotid artery kubva kune cavernous segment kusvika kuM2 chikamu chepakati cerebral artery, chikamu cheA2 che anterior cerebral artery, chikamu cheP2 chemashure echeperal artery, basilar artery, uye intracranial. artery.chikamu che vertebral artery.
Ongororo dzese dzeradiological dzakaitwa neuroradiologist (JYK), uyo aisaziva nezvese data rekiriniki nerabhoritari.Kuvimbika kwechiyero chekuona pakati pevacherechedzi kwakaongororwa nechipiri akadzidziswa radiographer (JYC) pa700 zvidzidzo zvakasarudzwa uye mukati memwedzi miviri mushure mekuverenga kwekutanga.Ongorora kuvimbika mukati memucherechedzi.Kuongororwa kwekuona kwePVWMH, DWMH, uye ICAS kwakaratidza yakanaka inter-nyanzvi (Cohen-weighted kappa: 0.7, 0.81, uye 0.67, zvichiteerana; n = 700) uye mukati-nyanzvi (Cohen-weighted kappa: 0.92, 0.88, uye 0 . 65, zvichiteerana; n = 1339) protocol.
CAC mamakisi akaongororwa muvanhu vakaita CT kuti vaongorore CAC mukati memakore mashanu europi MRI uye MRA39.Pavanhu 1,337, 686 vakavhenekwa uropi pazuva rimwe chete uye 651 pane rimwe zuva mukati memakore mashanu.
Nzvimbo dzeSeoul neSuwon dzakashandisa mAc (310 mA × 0.4 s) chubhu ikozvino pa 2.5 mm ukobvu, 400 ms kutenderera nguva, 120 kV tube voltage, uye 124 ECG-inotsamira dose modulation.Maererano naAgatston et al.40, CAC yakaverengwa kubva ku4 epicardial coronary arteries (kuruboshwe rworuboshwe, ruboshwe ruchidzika ruchidzika, ruboshwe circumflex, uye rworudyi coronary arteries).Iyo CT technician yakapofumadzwa nechero ruzivo nezvenyaya uye chibodzwa cheCAC chakatemwa pachishandiswa HEARTBEAT-CS software (Philips, Cleveland, OH, USA).Zvibodzwa zveCAC zvakakamurwa kuita mapoka matatu: 0, 1-100, uye > zana.
Baseline maitiro akafananidzwa pakati pezvidzidzo zvine uye zvisina cerebral WMH vachishandisa χ2 bvunzo yecategorical variables uye Mudzidzi's t-test kana Mann-Whitney bvunzo yezvinoramba zviripo, sezvakakodzera.Anowanzo kugovaniswa akasiyana anounzwa seanoreva ± chiyero kutsauka, nepo zvisingawanzo kugovaniswa siyana zvinoratidzwa sepakati uye interquartile renji.Dummy akasiyana akaunzwa nekuda kwekushaikwa kwemhando dzemhando dzakasiyana.
Multivariate logistic regression analysis yakaitwa kuverenga odds ratios (ORs) uye 95% nguva dzekuvimba (CIs) kuongorora hukama pakati pehuropi WMH neCAC zvibodzwa uye njodzi dzeatherosclerosis.Sezvo huwandu hweHHH huchiwedzera nezera uye hunosiyana nepabonde, zvose zvinongororwa zvakasiyana-siyana zvakaitwa kuti zviongorore kushamwaridzana pakati pezvimwe zvakasiyana-siyana uye HHH18 yakagadziriswa yezera uye zvepabonde.Imwe multivariate logistic regression modhi yakashandiswa kuongorora kana CAC mamaki ane yakazvimirira kubatana nehuropi SHG, kunyangwe mushure mekugadzirisa atherosclerosis ngozi zvinhu uye ICAS sezvinovhiringidza zvinhu zvakanzi zvakabatana neSHH mumishumo yapfuura10, 26, 27, 41 Muenzaniso 1 wakagadziridzwa kune zera uye hutano, Muenzaniso 2 wakagadziridzwa kune zera, zvepabonde, uye zvinokonzerwa nehutachiona hwehutachiona (BMI, hypertension, chirwere cheshuga, dyslipidaemia, ikozvino kana kuti aimbosvuta fodya, kurovedza muviri nguva dzose, coronary disease nhoroondo yechirwere chemoyo uye cystine levels. )adjusted;Muenzaniso 3 wakagadziridzwa zera, murume kana mukadzi, njodzi zvinhu zveatherosclerosis, uye kuvapo kweICAS.Kuvapo kwehuropi WMH kwakaongororwa zvinoenderana neCAC mamakisi zvikamu uchishandisa CAC mamakisi 0 sebhenji.
Kuongorora kwenhamba kwakaitwa pachishandiswa Stata vhezheni 16.1 (StataCorp, College Station, Texas, USA) uye R studio shanduro 3.6.3 (RStudio, Boston, Massachusetts, USA).Mbiri-miswe p-tsika <0.05 yaionekwa seyakakosha.
Maitiro ekutanga evanhu ve1337 anoratidzwa muTebhu 1. Nguva yezera yevatori vechikamu, inofungidzirwa kubva panguva yeMRI yeuropi, yaiva 51.63 ± 9.20 makore, uye 86.54% yehuwandu hwekudzidza vaiva varume.Izvo zvinokonzerwa nengozi yeatherosclerosis muboka iri yaive ikozvino kana yapfuura kusvuta (57.82%), inoteverwa nedyslipidemia (51.76%) uye hypertension (28.65%).Panyaya yezvakasiyana-siyana zveradiological, varwere zana nemakumi mashanu nevasere (11.82%) vaive nePVWMH, 148 (11.07%) vaive neDMH, uye 21 (1.57%) vaive neICAS.Panyaya yezvibodzwa zveCAC, 849 zvidzidzo (63.5%) vaive neCAC mamaki e0, 332 (24.83%) vaive nezvibodzwa pakati pe0 ne100, uye 156 (11.67%) vaive nezvibodzwa zvinopfuura zana.
Mukuongorora kusingaenzaniswi, makore, hutano, uye njodzi dzakawanda dzeatherosclerosis, kunze kweBMI, dyslipidemia, uye ikozvino kana kusvuta kwekare, zvakabatanidzwa zvakanyanya nekuvapo kwehuropi HHH (p <0.05) (Tafura 2).Vanhu vane PVWMH neDMH vaive vakura uye vaive nemutoro wakakura wehypertension, chirwere cheshuga, nhoroondo yecoronary artery disease, CAC, uye ICAS kupfuura vanhu vasina PVWMH neDMH.Mukuongorora kusingaenzaniswi, chikamu chepamusoro chevakadzi uye zvidzidzo muboka reWMH zvakashuma kuti vakashandisa nguva dzose.Iyo yepakati (interquartile range; IQR) CAC yaive 62 (IQR 0-269.5) muboka rePVWMH uye 46.5 (IQR 0-192) muboka reDMH.Kugoverwa kwezvikamu zveCAC nekuvapo kwePVWMH uye DWH kunoratidzwa mufig.2. Chikamu chezvikamu zvine zvibodzwa zvepamusoro zveCAC zvakawedzera nedhigirii recomorbid WMH.
Muzana wezvikamu zveCAC zvibodzwa zvichibva pakuva nePVMWH (a), DWMH (b), uye PVWMH kana DWMH (c).Calcification ye coronary arteries yeSAS, white matter hyperintensity SHG, periventricular white matter hyperintensity HVBV, deep white matter hyperintensity SHVH.
Multivariate regression analysis yakagadziridzwa kwezera (OR 1.13; 95% CI 1.10-1.16; OR 1.11; 95% CI 1.08-1.14) uye hypertension (OR 2.29; 95% CI 1.50-3.50, OR 1.20% CI 1.2-3, 1.98-1.98) .zvakateerana) iPVWMH mushure mekugadzirisa zera, zvepabonde, atherosclerosis ngozi zvinhu (BMI, hypertension, chirwere cheshuga, dyslipidemia, ikozvino kana yaimbova kusvuta, kurovedza muviri, nhoroondo ye coronary artery disease, uye homocysteine ​​​​levels) uye yakazvimiririra inokosha yekiriniki inofanotaura yeDMH uye ICAS (ese p <0.05) (Tafura 3).Pakanga pasina kushamwaridzana kwakakosha pakati peWMH yakagadziridzwa uye zvepabonde, BMI, chirwere cheshuga kana dyslipidemia, nhoroondo yekusvuta, kana kurovedza muviri nguva dzose.
Kunyangwe mushure mekugadzirisa zvinhu zvinovhiringidza, zvikamu zvine zvibodzwa zvepamusoro zveCAC zvakaratidza kuwedzera kushamwaridzana neuropi GMI mune imwe nzira-inotsamira pakuenzanisa nereferensi zvikamu neCAC score ye 0. Nokuda kwePVWMH neDWMH, zvikamu zvine CAC yakakura kudarika 100 ( OR 5.45; 95% CI 3.11-9.54 kana 3.66; 95% CI 2.10-6.38) yakaratidza kushamwaridzana kukuru kudarika zvikamu neCAC scores ye0 kusvika ku100 (OR 2.22; 95% CI).1.36–3.61, KANA 1.59;95% CI 0.98–2.58).Kana tichienzanisa kushamwaridzana neCAC pakati pePVWMH nemapoka eDWMH, ose matatu emhando dzakasiyana-siyana dzekuongorora dzakaratidza kushamwaridzana kwepamusoro nePVWMH muzvikamu zvose zveCAC zvekugovera.Kuvapo kweICAS kwakaratidzawo kushamwaridzana kwakakosha nePVWMH (OR 3.97, 95% CI 1.31-12.06) uye DDMH (OR 7.11, 95% CI 2.33-21.77).
Kusiyana kweinflation coefficients kwakaverengerwa kune ese regression mamodheru kuti aongorore anogona multicollinearity, uye hapana dambudziko multicollinearity yakawanikwa (Supplementary Table 1 online).
Muchidzidzo ichi, njodzi yecerebral SHH yakawedzera nekuwedzera CAC mamakisi nenzira inotsamira mudosi, uye mhedzisiro yacho yaive yakakosha mushure mekugadzirisa kune comorbid njodzi zvinhu zveatherosclerosis.Zvigumisiro zvedu zvinopindirana nezvidzidzo zvekare zvinoratidza kushamwaridzana pakati peCAC uye uropi MRI kusagadzikana, kuwedzera kutsigira kushamwaridzana kweCAC necerebral small vessel atherosclerosis pamwe chete nemudziyo mukuru atherosclerosis29,30,31,32.
Sezvineiwo, mumatatu ese emhando dzekuongorora dzakasiyana-siyana, maOR ezvibodzwa zveCAC aive akakwira zvishoma muboka rePVWMH kupfuura muboka reDMH.Iyi misiyano inogona kunge yakakonzerwa nekuti misiyano yepathophysiological process uye njodzi inofungidzirwa pakati pePVWMH neDMH11,42,43.PVWMHs dzinowanzo symmetrically iripo mune ese ari maviri cerebral hemispheres, zvichiratidza kuti diffuse perfusion disorder, nepo DWMHs kazhinji ine asymmetric distribution, zvichiratidza kuti inokonzerwa nefocal perfusion disorder.Sezvo nharaunda yeperiventricular inopihwa neaterminal arteries yeakareba medulla uye perforating matavi [45], inonyanya kunetseka kana autoregulatory nzira dzekuchengetedza nguva dzose cerebral perfusion inokanganiswa ne arteriosclerosis kana lipoid hyalinosis [46, 47, 48, 49].Hypoperfusion uye ischemia inokura.Kunyanya, zvidzidzo zvakawanda zvakaratidza kuti zviratidzo zve systemic atherosclerosis, zvakadai sehypertension, chirwere cheshuga mellitus, uye kuvapo kweaortic atherosclerosis, inonyanya kubatanidzwa nePVWMH50,51,52,53, inotsigira zvatinowana kuti CAC chikamu, makore, uye arterial. hypertension yaive yakakwira maOR ePVWMH pane yeDMH mumamodheru ese.
Muchidzidzo ichi, kuvepo kweICAS kwaive kwakabatana nehuropi HHH, mhedzisiro inogona kutsanangurwa nekuti yakakosha stenosis yemahombe intracranial arteries inoderedza nharaunda kana yedunhu cerebral perfusion, uye iyi isingaperi hypoperfusion inobatsira kune fatty hyalinosis, inova nzira dziri pasi.kuvandudzwa kweWMH 26.54.
Zvichienderana nezvakawanda zvidzidzo zvekare3, 27, 28, 55 zvakaitwa mumapoka emarudzi akasiyana-siyana, chidzidzo chedu chakaratidzawo kuti zera uye hypertension zvakazvimiririra uye zvakanyanya kubatanidzwa nehuropi HBG mune multivariate analysis.Zvisinei, kushamwaridzana pakati peHHH nedzimwe njodzi dzeatherosclerosis dzakaratidza migumisiro yakavhenganiswa mumishumo yapfuura27,28,37,56.Zvikonzero zveiyi mhedzisiro dzakasiyana zvinogona kunge zvichikonzerwa nekusiyana kwehuwandu hwezvidzidzo, maitiro ekuona zvinhu zvine njodzi, kana nzira dzinoshandiswa kuongorora WMH, izvo zvinoda kuwedzera kudzidza.
Zvikamu zvinoverengeka zvechidzidzo ichi zvinofanirwa kucherechedzwa.Chekutanga, uku kudzokorodza ongororo yehuwandu hweAsia mune monobrand medical centre.Panogona kuva nengozi yekusarura kusarudzwa sezvo nhamba huru yevatori vechikamu chidzidzo vaiva vezera rekushanda, uye vanopfuura hafu yavo vaiva varume, nekuda kwemaitiro akasiyana eSouth Korea, izvo zvinoda kuti makambani agare achiongorora vashandi vavo.Kuderedza kusarura muzvidzidzo zveboka, zvenguva refu, kwenguva refu, uye zvidzidzo zvinotarisirwa seRotterdam Chidzidzo57 kana Framingham Chidzidzo58 chinofanira kuitwa.Kare, pakave nemishumo yakawanda inoshandisa Rotterdam Study kutarisa hukama pakati pehuropi SHG uye zvakasiyana-siyana zvinokonzera atherosclerosis Association pakati pemapoka uye zvidzidzo Framingham 4, 59, 60, 61, 62, 63. Zvisinei, sezvo pasina chimwe chezviripo. zvidzidzo zvakatarisana nekubatana pakati peGIBD neCCA muvanhu vakajairwa, mhedzisiro yedu ndeyekukosha kwekiriniki.Chechipiri, sezvo kuongororwa kweMRI kuchiitwa zvinoonekwa neradiologists, chinangwa chingave chisina kukwana.Zvisinei, takaedza kukunda chipingamupinyi ichi nekubatanidza nhamba huru yevatori vechikamu uye kutsanangura zvidzidzo zvine WMH iri pakati nepakati kana yepamusoro seboka rakanaka.Pamusoro pezvo, takaita inter-observer uye intra-observer bvunzo dzekuvimbika, uye mhedzisiro yakaratidza kubvumirana kwakanaka.Zvakambotaurwa zvakare kuti pane wirirano yepamusoro pakati penzira dzekuongorora kuona dzichishandisa chikero cheFazekas uye ongororo yevhoriyamu inoshandiswa kuongorora giredhi reWMH64,65.Chechitatu, vanhu vane maronda ehuropi havana kuverengerwa vachishandisa bhuku remibvunzo rakazvimiririra iro raisanganisira nhoroondo yekurapa yapfuura uye kuongororwa kwemifananidzo kwevanhu vane chirwere chakanyanya uye vangasasefa vanhu vane subclinical chirwere.Mukuwedzera, chirongwa cheMRI cheuropi chekuongorora hutano muchipatara chedu hachibatanidzi mifananidzo yakagadziridzwa, saka pane mukana wekushayikwa kuongororwa kwehutano hwehuropi hunosimudzira, izvo zvisingaoneki pamifananidzo yeT1-inorema, T2-inorema uye FLAIR, uye kururama hakuna kukwirira.Kuenzaniswa neMRA kukwidziridzwa, kuvapo kweICAS kwakanzi kwakadzikira.Chechina, sezvo vazhinji vevatori vechikamu muchidzidzo ichi vaibva kuvanhu vane hutano uye vazhinji vakanga vasina chero chirwere, chikamu chevanhu vanotambura neICAS chakanga chiri chiduku.
Zvakadaro, chidzidzo ichi chaisanganisira vanhu vane hutano kupfuura zvidzidzo zvakapfuura zvichitarisa kushamwaridzana kuri pakati peSHG neSAS, uye sekuziva kwedu, iyi ndiyo ongororo yekutanga kusanganisira vanhu vakuru vane hutano pasina kudoma murume kana makore.Kuganhurirwa kwechidzidzo 31,32.
Kukosha kwehuropi WMH uye zvakasiyana-siyana zvinosangana neurological disorders zvakadai sedementia uye sitiroko zvinoratidzwa nekuda kwekuwedzera kunoshamisa kwekuwanika kwekufungidzira kwehuropi uye hupenyu hwehupenyu, asi zvirwere izvi zvinoramba zvisingakundiki.Kuvapo kweHHH maronda muuropi kwakabatana nekunyanya kuderera kwekuziva, dementia, kuora mwoyo, uye sitiroko, uye kune humbowo huri kukura hwekuti kudzora dzimwe njodzi dzeatherosclerosis dzinogona kudzivirira HHH12, 13, 14, 15, 16, 17, 18 , 19, 20, 21, 22, 23, 66, 67, 68, 69. Nokudaro, zvigumisiro zvedu zvinogona kupa uchapupu hwekuongorora vanhu vari pangozi yehuropi HHH, chinhu chinokosha chengozi uye chirevo chezvirwere zvakasiyana-siyana zvetsinga, maererano ne zvibodzwa zveCAC, nokudaro zvichiratidza varwere vanogona kubatsirwa nehutsinye hwekuongororwa uye kupindira kwekurapa.kana CAC inobata basa rinokosha uye rakazvimiririra mukugadzirwa kweWMH mune zvidzidzo zvenguva refu uye zvinotarisirwa kubva kumatunhu akasiyana-siyana, mapoka ezera uye mapoka emarudzi, uye mamwe maMRI zviratidzo zvecerebral small vessel disease inofanirawo kuiswa kuti inzwisise.
Mukupedzisa, CAC mamakisi pamwe nezera uye hypertension zvakabatanidzwa zvakanyanya nehuropi WMH muhuwandu hukuru hune hutano.Chiyero cheCAC chiratidzo chekuremerwa kweatherosclerotic uye ine mukana wekufanotaura njodzi yehuropi hweHHH mukuita kwekiriniki.
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