Enlarged Perivascular Spaces on MRI Are a Feature of Cerebral Small Vessel Disease
Enlarged Perivascular Spaces on MRI Are a Feature of Cerebral Small Vessel Disease
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DOI：
10.1161/strokeaha.109.564914
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发表时间：
2010-03-01
期刊：
影响因子：
8.3
通讯作者：
Wardlaw, Joanna M.
中科院分区：
文献类型：
--
作者：
Doubal, Fergus N.;MacLullich, Alasdair M. J.;Wardlaw, Joanna M.
背景和目的-脑血管周围间隙扩大很常见，但通常被忽视，其病理生理学也不确定。它们可能反映了潜在的脑小血管疾病。我们确定是否扩大血管周围空间与腔隙性中风亚型和白色物质高信号，标记建立小vessel diseases.Materials和Methods，我们前瞻性招募急性缺血性腔隙性或皮质性中风患者。还招募了与之匹配的非卒中对照受试者。在T2加权MRI和白色高信号上，我们将基底节和半卵圆中心扩大的血管周围间隙评定为0至4（0 =无，4 = >40）。我们比较了中风亚型和对照组之间的血管周围空间扩大，并评估了与血管危险因素和白色物质hyperintensities.Results-We招募了350例患者，129腔隙性，124皮质中风，和97年龄匹配的对照组。校正血管危险因素和白色高信号后，血管周围间隙扩大与腔隙性卒中亚型相关（P = 0.04）;基底节区血管周围间隙扩大与腔隙性卒中亚型相关（P = 0.003），深部（P = 0.02）和脑室周围白色物质高信号（P = 0.01）;在所有350名受试者中，血管周围间隙总扩大与深（P < 0.001）和脑室周围（P < 0.001）白色物质高信号。结论-虽然在有血管危险因素和中风的患者中普遍存在，扩大的血管周围空间与腔隙性缺血性中风和白色物质高信号特别相关。进一步的研究应该确定这种关联的机制，同时包括足够的控制来解释中风和血管危险因素。在小血管疾病的研究中，不应忽视血管周围间隙的扩大。（中风。2010;41：450-454）。
Background and Purpose-Enlarged perivascular spaces in the brain are common but generally overlooked and of uncertain pathophysiology. They may reflect underlying cerebral small vessel disease. We determined whether enlarged perivascular spaces were associated with lacunar stroke subtype and white matter hyperintensities, markers of established small vessel disease.Materials and Methods-We prospectively recruited patients with acute ischemic lacunar or cortical stroke. Age-matched nonstroke control subjects were also recruited. We rated basal ganglia and centrum semiovale enlarged perivascular spaces 0 to 4 (0 = none, 4 = >40) on T2-weighted MRI and white matter hyperintensities. We compared enlarged perivascular spaces between stroke subtypes and control subjects and assessed associations with vascular risk factors and white matter hyperintensities.Results-We recruited 350 patients; 129 lacunar, 124 cortical stroke, and 97 age-matched control subjects. Adjusting for vascular risk factors and white matter hyperintensities, total enlarged perivascular spaces were associated with lacunar stroke subtype (P = 0.04) in the acute stroke group (n = 253); basal ganglia enlarged perivascular spaces were associated with lacunar stroke subtype (P = 0.003), deep (P = 0.02) and periventricular white matter hyperintensities (P = 0.01); in all 350 subjects, total enlarged perivascular spaces were associated with deep (P < 0.001) and periventricular (P < 0.001) white matter hyperintensities.Conclusions-Although prevalent in patients with vascular risk factors and stroke, enlarged perivascular spaces are specifically associated with lacunar ischemic stroke and white matter hyperintensities. Further studies should determine the mechanism of this association while including adequate controls to account for stroke and vascular risk factors. Enlarged perivascular spaces should not be overlooked in studies of small vessel disease. (Stroke. 2010;41:450-454.)