| Part one MRI features of intracranial perivascular spaces in patients-with multiple sclerosisObjective:To investigate the imaging features and influencing factors of intracranial perivascular spaces(PVS)in patients with multiple sclerosis.Methods:This study retrospectively analyzed the imaging features of intracranial PVS of patients diagnosed with MS(n=46)and healthy volunteers(n=35)matched with their sex and age from the second hospital of hebei medical university from 2017-1-1 to 2018-12-31.All MRI images were interpreted and analyzed by experienced neuroimaging doctors using RadiAnt DICOM Viewer 2.2.4 software tools,and the clinical information was blinded to them.The main analysis and measurement indicators included:1)measured the diameter and the number of PVS in the layers of subcortical white matter,semi-oval center and basal ganglia on T2-weighted images;2)compared the differences in the size and the number of intracranial PVS between MS patients and healthy groups;3)divided MS patients into acute attack and remission groups according to clinical characteristics,and analyzed the differences of the size and the number of intracranial PVS between the two groups;4)according to the number of episodes,the patients were divided into the first episode group and the relapse group,then analyzed the differences of intracranial PVS features with age,sex,blood and cerebrospinal fluid indicators between the two groups.Results:The incidences of PVS in subcortical white matter,semi-oval center and basal ganglia of MS patients(female:male= 31:15,age=37.59± 11.76)were 93.5%,93.5% and 95.7%.In contrast,the incidences of PVS at three different layers in the control group(female:male=26:9,age=35±11.62)were 85.7%,60.0% and 88.6%,respectively.There was significant difference in the incidence of PVS in the semi-oval center between the two groups(P<0.001),but there was no significant difference in the other layers(subcortical white matter:P=0.282;basal ganglia:P=0.395).Subcortical white matter(number:9 vs 3;size: 5 vs 0),semi-oval center(number:5 vs 1;size:2.5 vs 0),basal ganglia(number:6 vs 3;size: 2 vs 1)in MS patients were significantly larger than those in control group(P<0.001).Compared with remission period,the number and the size of PVS in different layers of MS patients had significant difference(number of subcortical white matter:9 vs 4;size:5 vs 0,number of semioval center:6.5 vs 3;size:3 vs 0,number of basal ganglia:6.5 vs 4;size:3 vs 0;P<0.05).There were no significant differences in the number(P=0.867,P=0.767,P=0.868)and the size(P=0.807,P=0.332,P=0.400)of PVS between the first onset and relapse of MS in acute phase.There were no significant differences in the number(P=0.867,P=0.767,P=0.868)and the size(P=0.807,P=0.332,P=0.400)of PVS between the first onset and relapse of MS in acute phase.Conclusion:Intracranial PVS was not unique to MS patients,healthy people also appeared.Compared with the healthy control group,the number and diameter of PVS in subcortical white matter,semi-oval center and basal ganglia of MS patients were larger.The number and size of PVS might be related to the stage of the disease.There are more enlarged PVS in the onset stage than in the remission stage,but the number and size of PVS in the onset stage might not be related to the number of episodes.Part two MRI features of intracranial perivascular spaces in patientswith neuromyelitis optica spectrum disordersObjective:To investigate the imaging features and influencing factors of intracranial perivascular spaces(PVS)in patients with neuromyelitis opticaspectrum disorders(NMOSD).Methods:This study retrospectively analyzed the imaging features of intracranial PVS of patients diagnosed NMOSD(n=65)and healthy volunteers(n=35)matched with their sex and age from the second hospital of hebei medical university from 2017-1-1 to 2018-12-31.All MRI images were interpreted and analyzed by experienced neuroimaging doctors using RadiAnt DICOM Viewer 2.2.4 software tools,and the clinical information was blinded to them.The main analysis and measurement indicators included:1)measured the diameter and the number of PVS in the layers of subcortical white matter,semi-oval center and basal ganglia on T2-weighted images;2)compared the differences in the size and the number of intracranial PVS between NMOSD patients and healthy group;3)divided NMOSD patients into acute attack and remission groups according to clinical characteristics,and analyzed the differences of the size and the number of intracranial PVS between the two groups;4)according to the number of episodes,the patients were divided into the first episode group and the relapse group,then analyzed the differences of intracranial PVS features with age,sex,blood and cerebrospinal fluid indicators between the two groups.Results:In patients with NMOSD(female:male= 56:9,age= 40.22± 11.75),the incidence of PVS were 87.7%,83.1% and 81.5% in subcortical white matter,semi-oval center and basal ganglia.Incomparison,the incidence of PVS in the control group(female:male=26:9,age=35±11.62)were 85.7%,60.0% and 88.6%,respectively.There were no significant differences in the incidence of PVS at three levels between the two groups(P=0.765,P=0.360,P =0.360).Subcortical white matter(number:4 vs 3;size:1 vs 0),center of semi-oval(number:3 vs 1;size:1 vs 0)in NMOSD patients were significantly larger than those in the control group(P<0.05).Basal ganglia(number:3 vs 3;size: 1 vs 1)were no significant differences(P=0.445,P=0.312).Compared with the remission phase,the number of EPVS of subcortical white matter(3 vs 0)and semi-oval center(2 vs 0)in the acute attack phase showed statistically significant differences(P<0.001,P=0.003),the number of PVS of subcortical white matter(5 vs 4)and semi-oval center(3 vs 3),and the PVS of basal ganglia(size:2 vs 2,number:1 vs 1)showed no significant differences(P>0.05).The number and the size of PVS at different layers had no significant differences between the first attack and recurrence of acute NMOSD(P>0.05,number:P=0.743,P=1.00,P=0.101.Size:P=0.750,P=0.798,P=0.472).However,the comparison of general clinical data,blood and cerebrospinal fluid index between the two groups showed that there was a statistically significant difference in protein content of cerebrospinal fluid between the two groups(P=0.045),and there was no significant difference in the remaining indicators(P>0.05).Conclusion:Intracranial PVS presented in both patients with NMOSD and healthy control.Compared with healthy control,subcortical white matter and semioval center of patients with NMOSD have more PVS,larger diameter and no difference in basal ganglia.The size of intracranial PVS might be related to the stage of the disease.The diameter of PVS in the subcortical white matter and the semioval center enlarged during the onset.The number and size of intracranial PVS might not be related to the number of episodes.Part three A comparative study of imaging features of intracranialperivascular space in patients with multiple sclerosis andneuromyelitis optica spectrum disordersObjective:To compare the differences of intracranial PVS imaging features in MS and NMOSD patients.Methods:Case collection and intracranial PVS interpretation the same as part I and part II.Compared the differences of the number and size of intracranial PVS in different layers of the brain among the MS,NMOSD and control group,and the differences of the number and the size of intracranial PVS in different layers of the brain between MS and NMOSD patients were further compared.Results:There were significant differences in the number and the size of intracranial PVS in different layers of intracranial among MS,NMOSD and control group(P<0.05;number of subcortical white matter: 9 vs 4 vs 3;size:5 vs 1 vs 0;number of semioval center:5 vs 3 vs 1;size:2.5 vs 1 vs 0;number of basal ganglia:6 vs 3 vs 3;size: 2 vs 1 vs 1).There were significant differences in the number and size of PVS in different layers of intracranial between MS and NMOSD groups(P<0.05;the number of subcortical white matter:9 vs 4;size:5 vs 1;number of semioval center: 5 vs 3;size: 2.5 vs 1;number of basal ganglia:6 vs 3;size:2 vs 1).Conclusion:Intracranial PVS might be associated with central nervous system immune inflammation.Compared with healthy people,patients with MS and NMOSD have more PVS in different intracranial layers and have larger diameter.PVS might be one of the imaging features that distinguished MS from NMOSD,compared with NMOSD patients,MS had more PVS and larger diameter in different layers of intracranial. |
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