Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Georgetown Preparatory School, North Bethesda, Maryland, USA.
Stroke Vasc Neurol. 2023 Apr;8(2):144-150. doi: 10.1136/svn-2022-001611. Epub 2022 Sep 28.
The association between perivascular space (PVS) and white matter hyperintensity (WMH) has been unclear. Normal-appearing white matter (NAWM) around WMH is also found correlated with the development of focal WMH. This study aims to investigate the topological connections among PVS, deep WMH (dWMH) and NAWM around WMH using 7 Tesla (7T) MRI.
Thirty-two patients with non-confluent WMHs and 16 subjects without WMHs were recruited from our department and clinic. We compared the PVS burden between patients with and without WMHs using a 5-point scale. Then, the dilatation and the number of PVS within a radius of 1 cm around each dWMH were compared with those of a reference site (without WMH) in the contralateral hemisphere. In this study, we define NAWM as an area within the radius of 1 cm around each dWMH. Furthermore, we assessed the spatial relationship between dWMH and PVS.
Higher PVS scores in the centrum semiovale were found in patients with >5 dWMHs (median 3) than subjects without dWMH (median 2, p = 0.014). We found there was a greater dilatation and a higher number of PVS in NAWM around dWMH than at the reference sites (p<0.001, p<0.001). In addition, 79.59% of the dWMHs were spatially connected with PVS.
dWMH, NAWM surrounding WMH and MRI-visible PVS are spatially correlated in the early stage of cerebral small vessel disease. Future study of WMH and NAWM should not overlook MRI-visible PVS.
血管周围间隙（PVS）与脑白质高信号（WMH）之间的关联尚不清楚。WMH 周围的正常外观白质（NAWM）也与局灶性 WMH 的发展相关。本研究旨在使用 7 特斯拉（7T）磁共振成像（MRI）研究 PVS、深部 WMH（dWMH）和 WMH 周围 NAWM 之间的拓扑连接。
从我院和临床招募了 32 例非融合性 WMH 患者和 16 例无 WMH 患者。我们使用 5 分制比较了有和无 WMH 患者之间的 PVS 负担。然后，比较了每个 dWMH 周围 1cm 半径内 PVS 的扩张和数量与对侧半球参考部位（无 WMH）的扩张和数量。在本研究中，我们将 NAWM 定义为每个 dWMH 周围 1cm 半径内的区域。此外，我们评估了 dWMH 和 PVS 之间的空间关系。
在半卵圆中心，发现有 >5 个 dWMH（中位数 3 个）的患者 PVS 评分高于无 dWMH 的患者（中位数 2 个，p=0.014）。我们发现 dWMH 周围的 NAWM 扩张和 PVS 数量都大于参考部位（p<0.001，p<0.001）。此外，79.59%的 dWMH 与 PVS 具有空间相关性。
在脑小血管病的早期，dWMH、WMH 周围的 NAWM 和 MRI 可见的 PVS 在空间上是相关的。未来对 WMH 和 NAWM 的研究不应忽视 MRI 可见的 PVS。
