Kim Jee Young, Nam Yoonho, Kim Sumin, Shin Na-Young, Kim Hyun Gi
From the Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 1021 Tongil-ro, Eunpyeong-gu, Seoul 03312, Korea (J.Y.K., H.G.K.); Division of Biomedical Engineering, Hankuk University of Foreign Studies, Seoul, Korea (Y.N., S.K.); Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea (N.Y.S.); and Department of Radiology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea (N.Y.S.).
Radiology. 2023 Apr;307(2):e221314. doi: 10.1148/radiol.221314. Epub 2023 Jan 17.
Background Mounting evidence suggests that perivascular spaces (PVSs) visible at MRI reflect the function of the glymphatic system. Understanding PVS burden in neonates may guide research on early glymphatic-related pathologic abnormalities. Purpose To perform a visual and volumetric evaluation of PVSs that are visible at MRI in neonates and to evaluate potential associations with maturation, sex, and preterm birth. Materials and Methods In this retrospective study, T2-weighted brain MRI scans in neonates from the Developing Human Connectome Project were used for visual grading (grades 0-4) of PVSs in the basal ganglia (BG) and white matter (WM) and for volumetric analysis of BG PVSs. The BG PVS fraction was obtained by dividing the BG PVS volume by the deep gray matter volume. The association between postmenstrual age at MRI and BG PVS burden was evaluated using linear regression. PVS burden was compared according to sex and preterm birth using the Mann-Whitney test. Results A total of 244 neonates were evaluated (median gestational age at birth, 39 weeks; IQR, 6 weeks; 145 male neonates; 59%), including 88 preterm neonates (median gestational age at birth, 33 weeks; IQR, 6 weeks; 53 male neonates; 60%) and 156 term neonates (median gestational age at birth, 40 weeks; IQR, 2 weeks; 92 male neonates; 59%). For BG PVSs, all neonates showed either grade 0 (90 of 244; 37%) or grade 1 (154 of 244; 63%), and for WM PVSs, most neonates showed grade 0 (227 of 244; 93%). The BG PVS fraction demonstrated a negative relationship with postmenstrual age at MRI ( = -0.008; < .001). No evidence of differences was found between the sexes for BG PVS volume ( = .07) or BG PVS fraction ( = .28). The BG PVS volume was smaller in preterm neonates than in term neonates (median, 45.3 mm [IQR, 15.2 mm] vs 49.9 mm [IQR, 21.3 mm], respectively; = .04). Conclusion The fraction of perivascular spaces (PVSs) in the basal ganglia (BG) was lower with higher postmenstrual age at MRI. Preterm birth affected the volume of PVSs in the BG, but sex did not. © RSNA, 2023 See also the editorial by Huisman in this issue.
背景 越来越多的证据表明，MRI上可见的血管周围间隙（PVS）反映了类淋巴系统的功能。了解新生儿的PVS负荷可能会为早期类淋巴系统相关病理异常的研究提供指导。目的 对新生儿MRI上可见的PVS进行视觉和容积评估，并评估其与成熟度、性别和早产的潜在关联。材料与方法 在这项回顾性研究中，利用人类连接组计划中新生儿的T2加权脑MRI扫描对基底节（BG）和白质（WM）中的PVS进行视觉分级（0-4级），并对BG PVS进行容积分析。BG PVS分数通过将BG PVS体积除以深部灰质体积获得。使用线性回归评估MRI时的月经后年龄与BG PVS负荷之间的关联。使用Mann-Whitney检验根据性别和早产情况比较PVS负荷。结果 共评估了244例新生儿（出生时中位胎龄39周；四分位间距6周；145例男婴，占59%），其中包括88例早产儿（出生时中位胎龄33周；四分位间距6周；53例男婴，占60%）和156例足月儿（出生时中位胎龄40周；四分位间距2周；92例男婴，占59%）。对于BG PVS，所有新生儿均表现为0级（244例中的90例，占37%）或1级（244例中的154例，占63%），对于WM PVS，大多数新生儿表现为0级（244例中的227例，占93%）。BG PVS分数与MRI时的月经后年龄呈负相关（r = -0.008；P <.001）。在BG PVS体积（P =.07）或BG PVS分数（P =.28）方面，未发现性别差异。早产儿的BG PVS体积小于足月儿（中位数分别为45.3 mm[四分位间距15.2 mm]和49.9 mm[四分位间距21.3 mm]；P =.04）。结论 MRI时月经后年龄越大，基底节（BG）中血管周围间隙（PVS）的分数越低。早产影响BG中PVS的体积，但性别不影响。©RSNA，2023 另见本期Huisman的社论。
