A Preliminary Study Between Enlarged Perivascular Spaces And Cerebral Small Vessel Disease

Part ⅠA preliminary study of the correlation between Enlarged Perivascular Spaces and Cerebral Small Vessel DiseaseObjective:To investigate the imaging features on MRI of Enlarged perivascular spaces and their correlation with Cerebral small vessel disease.Method:222patients with ischemic stroke were recruited consecutively in Jinling Hospital from October2011to February2012. Brain MRI, including DWI and FLAIR, was applied to estimate the numbers and distribution of EPVS in all the subjects. According to the location and number of EPVS, all patients were classified into2groups. Clinical data were obtained and compared among patients with different grades of EPVS. Logistic regression analysis was employed to confirm the relevant factors of EPVS.Result:Among the222subjects included, Hypertension, age, the number of lacunar infarcts and severity of white matter lesions were associated with EPVS in basal ganglia. Uric acid and the number of lacunar infarcts as well as severity of white matter lesions were associated with EPVS in centrum ovale. Multivariate analysis indicated that severity of white matter lesions (OR=3.5%,95%CI:1.734-7.391, P=0.001) and the number of lacunar infarcts (OR=2.946,95%CI:1.539-5.639, P=0.001) were independent risk factors for EPVS in basal ganglia. Uric acid (OR=1.007,95%CI:1.001-1.014, P=0.035)、severity of white matter lesions (OR=1.678,95%CI:1.135-2.480, P=0.01) and the number of lacunar infarcts (OR=1.557,95%CI:1.01-2.401, P=0.045) were independent risk factors for EPVS in centrum ovale.Conclusion:EPVS in basal ganglia and in centrum ovale have different risk factors. The results suggest that the mechanism of EPVS in basal ganglia and in centrum ovale were different. EPVS might be considered as another MRI marker of cerebral small vessel disease. Part ⅡEvaluation of Enlarged Perivascular Space and its Clinicalsignificances in Patients with Cerebral Small Vessel DiseaseObjective:To investigate the imaging features on MRI of Enlarged perivascular spaces (EPVS) and their diagnostic value in patients with cerebral small vessel disease (CSVD)Method:174inpatients with CSVD and86without CSVD were recruited consecutively in Jinling Hospital from October2011to February2012. Brain MRI, including DWI and FLAIR, was applied to estimate the numbers and distribution of EPVS in all the subjects. A receiver operator characteristic curve (ROC) was constructed to determine the optimal diagnostic cut-off to CSVD.Result:Multivariate regression analysis showed that EPVS in basal ganglia (OR=1.491,95%CI1.165-1.909, P=0.002)、EPVS in centrum ovale (OR=1.279,95%CI1.022-1.601, P=0.032) were independent risk factors for the CSVD patients.The CSVD patients had more EPVS than the non-CSVD statistically either in basal ganglia or in centrum ovale (P<0.001). The optimal diagnostic cut-off point of EPVS in basal ganglia and centrum ovale to differentiate the CSVD from the non-CSVD was4and6separately. The area under the ROC curve, the sensitivity and specificity of basal ganglia and centrum ovale were0.859,72.4%,93.0%and0.808,65.5%,95.3%respectively. Conclusion:EPVS could be used to distinguish patients with CSVD from patients without CSVD, and main attention should be paid to the distribution of EPVS and the optimal diagnostic cut-off.