Descriptive Analysis of the Boston Criteria Applied to a Dutch-Type Cerebral Amyloid Angiopathy Population

被引:111
作者
van Rooden, Sanneke [1 ]
van der Grond, Jeroen [1 ]
van den Boom, Rivka [1 ]
Haan, Joost [2 ,3 ]
Linn, Jennifer [4 ]
Greenberg, Steven M. [5 ]
van Buchem, Mark A. [1 ]
机构
[1] Leiden Univ, Med Ctr, Dept Radiol, NL-2300 RC Leiden, Netherlands
[2] Leiden Univ, Med Ctr, Dept Neurol, NL-2300 RC Leiden, Netherlands
[3] Rijnland Hosp, Dept Neurol, Leiderdorp, Netherlands
[4] Univ Hosp Munich, Dept Neuroradiol, Munich, Germany
[5] Massachusetts Gen Hosp, Dept Neurol, Hemorrhag Stroke Res Program, Boston, MA 02114 USA
关键词
cerebral amyloid angiopathy; hemorrhage; MRI; neuroradiology; SUPERFICIAL SIDEROSIS; ALZHEIMERS-DISEASE; CLINICAL-DIAGNOSIS; HCHWA-D; HEREDITARY; HEMORRHAGE; MICROBLEEDS; AUTOPSY; LESIONS;
D O I
10.1161/STROKEAHA.109.554378
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose-Validation of the Boston criteria for the in vivo diagnosis of cerebral amyloid angiopathy (CAA) is challenging, because noninvasive diagnostic tests do not exist. Hereditary cerebral hemorrhage with amyloidosis-Dutch type is an accepted monogenetic model of CAA and diagnosis can be made with certainty based on DNA analysis. The aim of this study was to analyze and refine the existing Boston criteria in patients with hereditary cerebral hemorrhage with amyloidosis-Dutch type. Methods-We performed T2*-weighted MRI in 27 patients with hereditary cerebral hemorrhage with amyloidosis-Dutch type to assess the presence and location of microbleeds, intracranial hemorrhages, and superficial siderosis. Using the Boston criteria, subjects were categorized as having: no hemorrhages, possible CAA, probable CAA, and hemorrhagic lesions not qualifying for CAA. The sensitivity of the Boston criteria was calculated separately using intracranial hemorrhages only and using intracranial hemorrhages and microbleeds. Results-The sensitivity of the Boston criteria for probable CAA increased from 48% to 63% when microbleeds were included. For symptomatic subjects only, the sensitivity was 100%. No hemorrhages were identified in the deep white matter, basal ganglia, thalamus, or brainstem. Superficial siderosis, observed in 6 patients, did not increase the sensitivity of the Boston criteria in our study group. Conclusions-Our data show that using T2*-weighted MRI and including microbleeds increase the sensitivity of the Boston criteria. The exclusion of hemorrhages in the deep white matter, basal ganglia, thalamus, and brainstem does not lower the sensitivity of the Boston criteria. (Stroke. 2009;40:3022-3027.)
引用
收藏
页码:3022 / 3027
页数:6
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