From the Centre for Clinical Brain Sciences (A.C.C.J., G.W.B., M.S.S., M.J.T., U.C., F.M.C., R.B., D.J.G., O.K.L.H., A.G.M., I.M., K.H., S.W., T.M., M.C.V.-H., F.N.D., J.M.W.), University of Edinburgh, Scotland.
UK Dementia Research Institute (A.C.C.J., G.W.B., M.S.S., M.J.T., U.C., F.M.C., D.J.G., O.K.L.H., S.W., M.C.V.-H., F.N.D., J.M.W.), University of Edinburgh, Scotland.
Stroke. 2020 May;51(5):1503-1506. doi: 10.1161/STROKEAHA.120.029163. Epub 2020 Apr 8.
Background and Purpose- Perivascular spaces (PVS) around venules may help drain interstitial fluid from the brain. We examined relationships between suspected venules and PVS visible on brain magnetic resonance imaging. Methods- We developed a visual venular quantification method to examine the spatial relationship between venules and PVS. We recruited patients with lacunar stroke or minor nondisabling ischemic stroke and performed brain magnetic resonance imaging and retinal imaging. We quantified venules on gradient echo or susceptibility-weighted imaging and PVS on T2-weighted magnetic resonance imaging in the centrum semiovale and then determined overlap between venules and PVS. We assessed associations between venular count and patient demographic characteristics, vascular risk factors, small vessel disease features, retinal vessels, and venous sinus pulsatility. Results- Among 67 patients (69% men, 69.0±9.8 years), only 4.6% (range, 0%-18%) of venules overlapped with PVS. Total venular count increased with total centrum semiovale PVS count in 55 patients after accounting for venule-PVS overlap (β=0.468 [95% CI, 0.187-0.750]) and transverse sinus pulsatility (β=0.547 [95% CI, 0.309-0.786]) and adjusting for age, sex, and systolic blood pressure. Conclusions- Despite increases in both visible PVS and suspected venules, we found minimal spatial overlap between them in patients with sporadic small vessel disease, suggesting that most magnetic resonance imaging-visible centrum semiovale PVS are periarteriolar rather than perivenular.
背景与目的- 小静脉周围的血管周围间隙（PVS）可能有助于将脑间质液排出脑外。我们研究了磁共振成像上可见的疑似小静脉与 PVS 之间的关系。
方法- 我们开发了一种可视小静脉量化方法，以检查小静脉和 PVS 之间的空间关系。我们招募了腔隙性卒中和小非致残性缺血性卒中患者，并进行了脑部磁共振成像和视网膜成像。我们在梯度回波或磁化率加权成像上量化静脉，并在 T2 加权磁共振成像上量化脑白质半卵圆中心的 PVS，然后确定静脉和 PVS 之间的重叠。我们评估了静脉计数与患者人口统计学特征、血管危险因素、小血管疾病特征、视网膜血管和静脉窦搏动之间的相关性。
结果- 在 67 名患者（69%为男性，69.0±9.8 岁）中，只有 4.6%（范围，0%-18%）的静脉与 PVS 重叠。在 55 名患者中，在考虑到静脉-PVS 重叠（β=0.468[95%CI，0.187-0.750]）和横窦搏动（β=0.547[95%CI，0.309-0.786]）后，静脉总数随脑白质半卵圆中心 PVS 总数的增加而增加，并调整了年龄、性别和收缩压。
结论- 尽管可见 PVS 和疑似静脉数量均增加，但我们发现散发性小血管疾病患者之间的空间重叠很小，提示磁共振成像可见的脑白质半卵圆中心 PVS 大部分是动脉周围的，而不是静脉周围的。
