Enlarged perivascular spaces and cerebral small vessel disease.
Enlarged perivascular spaces and cerebral small vessel disease.
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DOI：
10.1111/ijs.12054
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发表时间：
2015-04
期刊：
影响因子：
--
通讯作者：
Wardlaw JM
中科院分区：
文献类型：
--
作者：
Potter GM;Doubal FN;Jackson CA;Chappell FM;Sudlow CL;Dennis MS;Wardlaw JM
在T2加权脑磁共振成像上，血管周围间隙（也称为Virchow-Robin间隙）扩大很常见，但其病因以及与一般脑血管疾病或衰老相对的小血管特异性尚不清楚。我们检测了血管周围间隙扩大与缺血性卒中亚型、其他小血管疾病标志物和常见血管危险因素之间的关系。我们前瞻性地招募了急性卒中患者，由卒中医生根据临床特征和脑磁共振成像进行诊断和分型。神经放射科医师以5分制评定基底节和半卵圆中心血管周围间隙扩大、白色病变、近期和陈旧性梗死和脑萎缩。我们评估了基底节区、半卵圆中心区和全部（基底节区和半卵圆中心区）血管周围间隙扩大、卒中亚型、白色病变、萎缩和血管危险因素之间的关系。在298例患者中（平均年龄68岁），在校正血管危险因素和白色病变后，基底节扩大的血管周围间隙与年龄增加（P = 0.001）、半卵圆中心扩大的血管周围间隙（P <0.001）、脑萎缩（P = 0.03）和腔隙性卒中亚型（P = 0.04）相关。半卵圆中心扩大的血管周围间隙主要与基底节扩大的血管周围间隙相关。血管周围间隙扩大与年龄增加（P = 0·01）、深部白色病变（P = 0·005）和既往卒中（P = 0·006）相关。血管周围间隙扩大与年龄、腔隙性卒中亚型和白色病变有关，应考虑作为脑小血管疾病的另一个磁共振成像标志物。需要在衰老、中风和痴呆的研究中进一步评估血管周围间隙扩大，以确定其病理生理学重要性。
Enlarged perivascular spaces (also known as Virchow–Robin spaces) on T2-weighted brain magnetic resonance imaging are common, but their etiology, and specificity to small vessel as opposed to general cerebrovascular disease or ageing, is unclear. We tested the association between enlarged perivascular spaces and ischemic stroke subtype, other markers of small vessel disease, and common vascular risk factors. We prospectively recruited patients with acute stroke, diagnosed and subtyped by a stroke physician using clinical features and brain magnetic resonance imaging. A neuroradiologist rated basal ganglia and centrum semiovale enlarged perivascular spaces on a five-point scale, white matter lesions, recent and old infarcts, and cerebral atrophy. We assessed associations between basal ganglia-, centrum semiovale- and total (combined basal ganglia and centrum semiovale) enlarged perivascular spaces, stroke subtype, white matter lesions, atrophy, and vascular risk factors. Among 298 patients (mean age 68 years), after adjusting for vascular risk factors and white matter lesions, basal ganglia–enlarged perivascular spaces were associated with increasing age (P = 0·001), centrum semiovale–enlarged perivascular spaces (P < 0·001), cerebral atrophy (P = 0·03), and lacunar stroke subtype (P = 0·04). Centrum semiovale–enlarged perivascular spaces were associated mainly with basal ganglia–enlarged perivascular spaces. Total enlarged perivascular spaces were associated with increasing age (P = 0·01), deep white matter lesions (P = 0·005), and previous stroke (P = 0·006). Enlarged perivascular spaces are associated with age, lacunar stroke subtype and white matter lesions and should be considered as another magnetic resonance imaging marker of cerebral small vessel disease. Further evaluation of enlarged perivascular spaces in studies of ageing, stroke, and dementia is needed to determine their pathophysiological importance.
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影响因子：
5.1
作者：
Cumurciuc, R;Guichard, JP;Chabriat, H
通讯作者：
Chabriat, H
影响因子：
11.2
作者：
Wardlaw, Joanna M.;Doubal, Fergus;Dhillon, Baljean
通讯作者：
Dhillon, Baljean
影响因子：
8.3
作者：
Doubal, Fergus N.;MacLullich, Alasdair M. J.;Wardlaw, Joanna M.
通讯作者：
Wardlaw, Joanna M.
影响因子：
7.7
作者：
Ferguson, SC;Blane, A;Frier, BM
通讯作者：
Frier, BM
影响因子：
8.3
作者：
Jackson, Caroline A.;Hutchison, Aidan;Sudlow, Cathie L. M.
通讯作者：
Sudlow, Cathie L. M.